=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255209839
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANDREA KAY MADRIGAL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2025
-----------------------------------------------------
Last Update Date | 10/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 621 S ILLINOIS AVE
-----------------------------------------------------
City | MASON CITY
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50401-5405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 641-428-6900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 204 S WASHINGTON AVE # 100
-----------------------------------------------------
City | ALBERT LEA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56007-2555
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-369-5701
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 13263
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | A187244
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------