Mariah Antigone, RN
Individual provider Active NPI Registered Nurse · Madison, WI
NPI 1114648284 · NPPES record last updated Sep 7, 2022
Key facts
- NPI
- 1114648284
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 222717 (WI)
- Practice address
- 2000 Fordem Ave
Madison, WI 53704-4600 - Phone
- (608) 280-2700
- NPI assigned
- Sep 7, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 222717 | WI | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 222717 | WI | Yes |
Addresses
Primary practice location
2000 Fordem Ave
Madison, WI 53704-4600
Mailing address
25 Kessel CT Ste 105
Madison, WI 53711-6227
Phone (608) 280-2700
Other names
- Mariah Pehoski
Other providers in Madison, WI
- Jyothsna Annyapu
- Darius Steven Ansari
- Thomas J Ansfield
- Ali Salah Antar
- David Gregory Anthony
- Janice M Antoniewicz-Werner
- Lisa (Pema) Antoniotti
- Anunson Chiropractic, SC
- Margaret Louise Anunson
- Wade E Anunson
All providers in Madison, WI · Registered Nurse in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.