Healthcare Provider Details

I. General information

NPI: 1275455834
Provider Name (Legal Business Name): MADELYN HENLE DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADELYN LIBBY

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 VALLEY HART RD
HARTWELL GA
30643-8517
US

IV. Provider business mailing address

2080 HARMONY RD
ELBERTON GA
30635-4144
US

V. Phone/Fax

Practice location:
  • Phone: 706-856-2601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP312546
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: