Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Madeline Nicole Detra

Individual provider General Practice Physician · NPI 1992634885

Madeline Nicole Detra is a General Practice Physician in Anoka, Minnesota. Licensed in Minnesota. Registered with an NPI since 2026.

Licensed in
MN
In the registry since
2026

Practice location Address checks out

2621 Greenhaven Rd
Anoka, MN 55303-5566
Phone: (763) 421-5540
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence 1346244274 (MN)

Record details

NPI number1992634885
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 16, 2026
Last updated in NPPESMay 16, 2026
Certification dateMay 16, 2026