MEDICARE: MADISON CHRISTINE KOWALSKI PA-C

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	363A00000X	Physician Assistant	10446	AZ

General Provider Information

NPI Number	:	1881431351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON CHRISTINE KOWALSKI PA-C

Provider Business Mailing Address
First Line	:	21321 E OCOTILLO RD STE 133-134
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-5996
Country	:	US
Telephone Number	:	480-987-5525
Fax Number	:	480-987-5115

Provider Business Practice Location Address
First Line	:	21321 E OCOTILLO RD STE 133-134
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-5996
Country	:	US
Telephone Number	:	480-987-5525
Fax Number	:	480-987-5115

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

Provider Enumeration Date	:	07/11/2024
Last Update Date	:	12/04/2025

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