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

Penny J Mader, CNP

Individual provider Nurse Practitioner · NPI 1518247758

Penny J Mader, CNP is a Nurse Practitioner in Provo, Utah. Qualified in 2011, 15 years ago. Practices with Emergency Physicians Southwest PC, a 98-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in New Mexico and Utah.

Years since qualifying
15
Licensed in
NM, UT
In the registry since
2011
Specialties on file
2
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

1055 N 500 W Attn Credentialing
Provo, UT 84604
Phone: (801) 354-8225
Fax: (801) 418-0941
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 — (575) 532-5455
  • 355 N Main St, Kanab, UT 84741-3260 — (435) 644-4100

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 13327156-4405 (UT)
Nurse Practitioner Taxonomy 363L00000X · Licence CNP-01828 (NM)

Record details

NPI number1518247758
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP
Sole proprietorNo
NPI enumeratedAugust 19, 2011
Last updated in NPPESMay 24, 2023
Certification dateMay 24, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Emergency Physicians Southwest Pc — 98 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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