MRS. MADELYN TYACK (NPI# 1629624259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629624259 |
| Entity Type | Individual |
| Full Name | MRS. MADELYN TYACK |
| Credential | NP |
| Practice Address |
11 Hunnewell Rd Scarborough ME 04074-9539 |
| Mailing Address |
263 Danforth St Portland ME 04102-3705 |
| Practice Telephone | 2072893600 |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP191162 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11 HUNNEWELL RD |
| City | SCARBOROUGH |
| State | ME |
| Zip Code | 04074-9539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407462443 | Jennifer Marlowe | Counselor | Crossroads Maine 71-us-1, Scarborough, ME 04074 | 2020-09-16 |
| 1508475724 | Whole Medicine LLC | Family Medicine | 2o Mussey Road, Suite 2, Scarborough, ME 04074 | 2020-07-23 |
| 1154957793 | Maria Robin Libby | Occupational Therapist | 144 Us-1 #4, Scarborough, ME 04074 | 2020-03-16 |
| 1558902932 | Daphne Berta Counseling P.C. | Counselor | 636 Route 1, Scarborough, ME 04074 | 2019-10-07 |
| 1619450574 | Louise Valati | Physical Therapist | Piper Shores, 15 Piper Road, Scarborough, ME 04074 | 2018-09-07 |
| 1770001315 | Emily Dunuwila | Massage Therapist | 51 Us Route One Suite R2, Scarborough, ME 04074 | 2017-09-04 |
| 1750808788 | Jill Daicey Hutchison | Physical Therapy Assistant | 67 Pine Point Road, Scarborough, ME 04074 | 2017-08-30 |
| 1457887580 | Rebecca Shaw | Social Worker | 119 Ash Swamp Road, Scarborough, ME 04074 | 2017-05-10 |
| 1184168767 | Jessica Ann Kaake | Occupational Therapist | 308 Us Route 1 Ste E1, Scarborough, ME 04074 | 2016-12-15 |
| 1356895056 | Nancy Gaudet | Counselor | 6 Catherine Drive, Scarborough, ME 04074 | 2016-08-10 |
| Find all providers in zip 04074 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225283229 | Cynthia S Heelan | Nurse Practitioner | 128 Burnham Rd, Scarborough, ME 04074-8892 | 2008-11-19 |
| 1790834588 | Colette Marie Beaumont | Nurse Practitioner | 180 Us Route 1 # 1, Scarborough, ME 04074 | 2007-01-09 |
| 1356954523 | Brittany Ann Giroux | Nurse Practitioner | 96 Campus Dr, Scarborough, ME 04074-7163 | 2020-08-27 |
| 1639787625 | Greer Catherine Hoffmann | Nurse Practitioner | 153 Us Route 1, Scarborough, ME 04074-9052 | 2020-07-16 |
| 1780218057 | Melinda Cormier | Nurse Practitioner | 96 Campus Dr, Scarborough, ME 04074-7163 | 2020-02-26 |
| 1730737065 | Thomas Charles Hopkins | Nurse Practitioner | 153 Us Route 1, Scarborough, ME 04074-9052 | 2019-08-29 |
| 1659931806 | Lisa Conway | Nurse Practitioner | 96 Campus Dr, Scarborough, ME 04074-7163 | 2019-06-19 |
| 1447714803 | Nicole L Laude | Nurse Practitioner | 96 Campus Dr, Scarborough, ME 04074-7163 | 2019-01-29 |
| 1477027019 | Kathryn Anne Ryan | Nurse Practitioner | 96 Campus Dr, Scarborough, ME 04074-7163 | 2019-01-16 |
| 1477066892 | Molly E Montgomery | Nurse Practitioner | 96 Campus Dr, Scarborough, ME 04074-7163 | 2017-11-07 |
| Find all providers in SCARBOROUGH | ||||
| City | SCARBOROUGH |
| Zip Code | 04074 |
Please comment or provide details below to improve the information on MRS. MADELYN TYACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.