Healthcare Provider Details

I. General information

NPI: 1194653980
Provider Name (Legal Business Name): MADISON GNAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 NEW HAMPSHIRE AVE NW STE 200
WASHINGTON DC
20037-2334
US

IV. Provider business mailing address

2039 NEW HAMPSHIRE AVE NW # 204
WASHINGTON DC
20009-3414
US

V. Phone/Fax

Practice location:
  • Phone: 202-833-5055
  • Fax:
Mailing address:
  • Phone: 202-833-5055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN500002772
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: