Groberg, Madison Rae

Groberg, Madison Rae is an sole proprietor health care provider with primary practice located at 115 Golf Course Rd Ste E , Logan UT 84321-5934. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Groberg, Madison Rae can be contacted via phone (435) 999-4059.

Contact Information

Primary practice address
115 Golf Course Rd Ste E Logan UT 84321-5934
Phone: (435) 999-4059
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA-2019 Idaho

Profile Details

NPI number 1043837404
LBN Legal business name Groberg, Madison Rae
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 1st, 2020
Last updated Apr 29th, 2026 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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