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General NPI Number Information
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NPI Number | 1205489085
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Entity Type | Individual
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Provider Name | MADELINE REED FURST APRN
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Gender | Female
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Dates
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Enumeration Date | 07/19/2019
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 2299 MOWRY AVE STE 3B
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City | FREMONT
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State | CA
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Zip | 94538-1621
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Country | US
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Telephone | 510-770-8040
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Fax |
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Provider Business Mailing Address
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Address Line | 215 LAKE AVE
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City | NEWTON
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State | MA
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Zip | 02461-1209
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95012263
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95012263
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License Number State | CA
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