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General NPI Number Information
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NPI Number | 1720694094
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Entity Type | Individual
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Provider Name | KATELYNN MADDEN APRN, CNS
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Gender | Female
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Dates
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Enumeration Date | 09/21/2020
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1001 MAIN ST STE 200
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City | PEORIA
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State | IL
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Zip | 61606-2035
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Country | US
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Telephone | 309-672-5682
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Fax | 309-672-3147
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Provider Business Mailing Address
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Address Line | 305 E MONROE ST
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City | METAMORA
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State | IL
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Zip | 61548-7115
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Country | US
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Telephone | 309-696-8183
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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 | 364SG0600X
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Taxonomy Name | Gerontology Clinical Nurse Specialist
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License Number | 209022044
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 209.022044
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License Number State | IL
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