Madison Grace Targgart
Student in an Organized Health Care Education/Training Program in Kendallville, IN. Individual provider (NPI-1).
NPI number1538030440
StatusActive
Last updated in NPPESSep 15, 2025
Details
- NPI
- 1538030440
- Entity type
- Individual (NPI-1)
- Name
- Madison Grace Targgart
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 15, 2025
- Certification date
- Sep 15, 2025
- Last updated
- Sep 15, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | IN | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | IN |
Practice location
2024 Granny Smith PlKendallville, IN 46755-2874
Phone 260-582-9099
Mailing address
2024 Granny Smith PlKendallville, IN 46755-2874
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