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General NPI Number Information
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NPI Number | 1487457974
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Entity Type | Individual
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Provider Name | MADDISON JOSEPHINE DAVIS WHITE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 16850 STATE HIGHWAY 58 S
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City | DECATUR
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State | TN
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Zip | 37322-5259
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Country | US
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Telephone | 423-334-3200
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Fax | 423-454-0125
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Provider Business Mailing Address
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Address Line | 297 CREEKWOOD COVE LN APT 8A
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City | LENOIR CITY
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State | TN
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Zip | 37772-6392
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Country | US
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Telephone | 865-518-3953
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 38492
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License Number State | TN
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