MEDICARE: ANGELA LEANNE MADEWELL FNP

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	678281	TX

General Provider Information

NPI Number	:	1417231044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA LEANNE MADEWELL FNP

Provider Business Mailing Address
First Line	:	450 CYPRESS CREEK RD BLDG 5
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-4194
Country	:	US
Telephone Number	:	512-249-1400
Fax Number	:	512-249-1800

Provider Business Practice Location Address
First Line	:	450 CYPRESS CREEK RD BLDG 5
Second Line	:
City	:	CEDAR PARK
State	:	TX
Zip	:	78613-4194
Country	:	US
Telephone Number	:	512-249-1400
Fax Number	:

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

Provider Enumeration Date	:	09/30/2011
Last Update Date	:	02/04/2022

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