Provider Demographics
NPI:1457223364
Name:REUER, MADISON
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:REUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25000 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:LOS MOLINOS
Mailing Address - State:CA
Mailing Address - Zip Code:96055-9657
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25000 4TH AVE
Practice Address - Street 2:
Practice Address - City:LOS MOLINOS
Practice Address - State:CA
Practice Address - Zip Code:96055-9657
Practice Address - Country:US
Practice Address - Phone:916-210-8905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty