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General NPI Number Information
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NPI Number | 1649977596
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Entity Type | Individual
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Provider Name | MADELYN KINGSLEY NP
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Gender | Female
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Dates
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Enumeration Date | 02/10/2023
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 3161 N WEBB RD STE 110
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City | WICHITA
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State | KS
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Zip | 67226-8105
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Country | US
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Telephone | 316-669-0777
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Fax |
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Provider Business Mailing Address
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Address Line | 12020 PACIFIC ST
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City | OMAHA
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State | NE
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Zip | 68154-3507
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Country | US
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Telephone | 402-210-2950
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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 | 5382186
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License Number State | KS
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