Provider Demographics
NPI:1033901012
Name:NORTHERN OPTIMAL HEALTH SOLUTIONS
Entity type:Organization
Organization Name:NORTHERN OPTIMAL HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERENA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:218-779-8522
Mailing Address - Street 1:21025 400TH ST
Mailing Address - Street 2:
Mailing Address - City:BAGLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56621-4682
Mailing Address - Country:US
Mailing Address - Phone:218-779-8522
Mailing Address - Fax:
Practice Address - Street 1:21025 400TH ST
Practice Address - Street 2:
Practice Address - City:BAGLEY
Practice Address - State:MN
Practice Address - Zip Code:56621-4682
Practice Address - Country:US
Practice Address - Phone:218-779-8522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service