MEDICARE: MADISON ROSSELLE ARANGO LONDONO APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024190335	VA

General Provider Information

NPI Number	:	1235970781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON ROSSELLE ARANGO LONDONO APRN

Provider Business Mailing Address
First Line	:	18030 TWIN FALLS LN
Second Line	:
City	:	MOSELEY
State	:	VA
Zip	:	23120-1829
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11934 W BROAD ST STE 110
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23233-1100
Country	:	US
Telephone Number	:	804-423-2100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2024
Last Update Date	:	06/06/2024

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