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General NPI Number Information
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NPI Number | 1770260630
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Entity Type | Individual
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Provider Name | MADISON PAIGE NALLEY
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Gender | Female
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Dates
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Enumeration Date | 07/03/2023
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Last Update Date | 07/03/2023
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Provider Practice Location Address
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Address Line | 2480 US 41 N STE H
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City | HENDERSON
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State | KY
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Zip | 42420-2376
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Country | US
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Telephone | 270-823-3875
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Fax |
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Provider Business Mailing Address
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Address Line | 2480 US HIGHWAY 41 N STE 80
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City | HENDERSON
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State | KY
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Zip | 42420-2300
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Country | US
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Telephone | 270-823-3875
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 46004284A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 285913
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License Number State | KY
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