Provider Demographics
NPI:1609574706
Name:MADDEN, HEIDI (APRN, CNP)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:MADDEN
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10870 GRAND LAKE RD
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:MN
Mailing Address - Zip Code:56320-9752
Mailing Address - Country:US
Mailing Address - Phone:320-333-7227
Mailing Address - Fax:
Practice Address - Street 1:30 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:MN
Practice Address - Zip Code:56307-9379
Practice Address - Country:US
Practice Address - Phone:320-845-2157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9769363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily