Healthcare Provider Details

I. General information

NPI: 1033023809
Provider Name (Legal Business Name): MADISON TOWNER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 EPPS BRIDGE PKWY
ATHENS GA
30606-6105
US

IV. Provider business mailing address

1850 EPPS BRIDGE PKWY
ATHENS GA
30606-6105
US

V. Phone/Fax

Practice location:
  • Phone: 706-478-2017
  • Fax:
Mailing address:
  • Phone: 706-478-2017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP292081
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: