Madonna Lee Kienlen, Peer Specialist
Peer Specialist in Ft. Washakie, WY. Individual provider (NPI-1).
NPI number1982116794
StatusActive
Last updated in NPPESNov 2, 2017
Details
- NPI
- 1982116794
- Entity type
- Individual (NPI-1)
- Name
- Madonna Lee Kienlen
- Credential
- Peer Specialist
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 2, 2017
- Last updated
- Nov 2, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | 2017-004-mm | WY | Yes |
Practice location
215 Ethete RoadFt. Washakie, WY 82514
Phone 307-335-8374 · Fax 307-335-8299
Mailing address
215 Ethete RoadFort Washakie, WY 82514
Phone 307-335-8374 · Fax 307-335-8299
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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