Healthcare Provider Details

I. General information

NPI: 1841180452
Provider Name (Legal Business Name): MADISON ELIZABETH HURST FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 07/07/2025
Certification Date: 07/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 N POINT PKWY STE 120
ALPHARETTA GA
30005-8892
US

IV. Provider business mailing address

960 N POINT PKWY STE 120
ALPHARETTA GA
30005-8892
US

V. Phone/Fax

Practice location:
  • Phone: 770-800-3353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN295304
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: