MEDICARE: MRS. LINDA ANN MADDEN CPNP

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	363LP0200X	Pediatric Nurse Practitioner	2-22468	TX

General Provider Information

NPI Number	:	1376649038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA ANN MADDEN CPNP

Provider Business Mailing Address
First Line	:	3624 SPRING GROVE DR
Second Line	:
City	:	BEDFORD
State	:	TX
Zip	:	76021-2220
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1935 MOTOR ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-7701
Country	:	US
Telephone Number	:	214-456-2586
Fax Number	:

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

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	07/08/2007

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