Provider Demographics
NPI:1538963327
Name:BOREL, MADELYN (RDN)
Entity type:Individual
Prefix:
First Name:MADELYN
Middle Name:
Last Name:BOREL
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33012 BOARDWALK DRIVE
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527
Mailing Address - Country:US
Mailing Address - Phone:757-771-3070
Mailing Address - Fax:
Practice Address - Street 1:33012 BOARDWALK DRIVE
Practice Address - Street 2:
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527
Practice Address - Country:US
Practice Address - Phone:757-771-3070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered