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NPI Code Detail

MEDICARE: MADISON ANN EBNET

MEDICARE: MADISON ANN EBNET
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1679422760
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON ANN EBNET
Provider Business Mailing Address
First Line : 12015 CITY VIEW LN SE
Second Line :
City : CHATFIELD
State : MN
Zip : 55923-1717
Country : US
Telephone Number : 507-923-1894
Fax Number :
Provider Business Practice Location Address
First Line : 1470 INDUSTRIAL DR NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-0700
Country : US
Telephone Number : 507-353-3023
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/22/2026

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Directions to “ MADISON ANN EBNET ” Practice Location

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