Healthcare Provider Details

I. General information

NPI: 1942129622
Provider Name (Legal Business Name): MADELIN CORRAO DNP-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 HUCKLEBERRY AVE
OMRO WI
54963-1851
US

IV. Provider business mailing address

922 CONGRESS ST
NEENAH WI
54956-4102
US

V. Phone/Fax

Practice location:
  • Phone: 920-685-7280
  • Fax:
Mailing address:
  • Phone: 920-615-5556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1870933
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: