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General NPI Number Information
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NPI Number | 1457226722
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Entity Type | Individual
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Provider Name | MADISON MACKENZIE MCRAE RN
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Gender | Female
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 4083 CLOUD SPRINGS RD
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City | RINGGOLD
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State | GA
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Zip | 30736-8411
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Country | US
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Telephone | 706-820-6350
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Fax |
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Provider Business Mailing Address
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Address Line | 496 E VIEW DR
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City | CHATTANOOGA
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State | TN
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Zip | 37404-5904
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 276601
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License Number State | GA
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