Healthcare Provider Details

I. General information

NPI: 1861304701
Provider Name (Legal Business Name): MADISON EMILY MOFFETT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 MALLORY LN STE 110
FRANKLIN TN
37067-8230
US

IV. Provider business mailing address

2801 CHARLOTTE AVE
NASHVILLE TN
37209-4035
US

V. Phone/Fax

Practice location:
  • Phone: 615-771-3024
  • Fax: 615-250-9251
Mailing address:
  • Phone: 615-250-9249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number7329
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: