Provider Demographics
NPI:1487457974
Name:WHITE, MADDISON JOSEPHINE DAVIS (FNP-C)
Entity type:Individual
Prefix:
First Name:MADDISON
Middle Name:JOSEPHINE DAVIS
Last Name:WHITE
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 CREEKWOOD COVE LN APT 8A
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-6392
Mailing Address - Country:US
Mailing Address - Phone:865-518-3953
Mailing Address - Fax:
Practice Address - Street 1:16850 STATE HIGHWAY 58 S
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TN
Practice Address - Zip Code:37322-5259
Practice Address - Country:US
Practice Address - Phone:423-334-3200
Practice Address - Fax:423-454-0125
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38492363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily