Provider Demographics
NPI:1578357422
Name:LENZ, MADELINE ANN (DO)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:ANN
Last Name:LENZ
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-4733
Mailing Address - Country:US
Mailing Address - Phone:920-832-2783
Mailing Address - Fax:
Practice Address - Street 1:100 N ONEIDA ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-4733
Practice Address - Country:US
Practice Address - Phone:920-832-2783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program