MRS. Madison Lane Fugate, PA
NPI #1912574823 in Lees Summit, Missouri
Provider Information
- NPI Number
- 1912574823
- Entity Type
- Individual
- Name
- MRS. Madison Lane Fugate, PA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA
- Enumeration Date
- Jun 9, 2021
- Last Updated
- Feb 2, 2022
Practice Location
- Address
- 2861 NE INDEPENDENCE AVE STE 201
- City
- Lees Summit
- State
- Missouri
- ZIP Code
- 64064-2379
- Phone
- (816) 525-2840
Specialties & Taxonomy Codes
| Specialty |
|---|
| Student in an Organized Health Care Education/Training Program |
| Physician Assistant |
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