MADELINE PARK DNP, APRN
NPI 1053746495
Nurse Practitioner in Salt Lake City, UT

Q: What is Madeline Park's NPI number?

The NPI number for Madeline Park is 1053746495. It was assigned to this individual provider in the NPPES registry on September 4, 2013.

Q: What is Madeline Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Madeline Park was last updated on January 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 04, 2013

100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113(206) 890-5699 Get Directions Write a Review

NPPES record last updated: January 30, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 30, 2026, Dec 9, 2025 (2 updates tracked since 2025).

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About Madeline Park Dnp, Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MADELINE PARK DNP, APRN (NPI 1053746495) is an individual nurse practitioner in Salt Lake City, Utah, licensed in Utah (11905610-4405) and active in the NPI registry since September 2013.

NPPES Registry Identity

NPI1053746495

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameMADELINE PARKCredential: DNP, APRN

Location Address100 N MARIO CAPECCHI DRSalt Lake City, UT 84113-1103

Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128

Phone(206) 890-5699

Sole ProprietorNo

Enumeration DateSeptember 4, 2013

Last NPPES UpdateJanuary 30, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 30, 2026

✔ NPI 1053746495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in UT · 11905610-4405

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

100 N MARIO CAPECCHI DR, Salt Lake City, UT 84113

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