Provider Demographics
NPI:1003271529
Name:DANGERFIELD, MADELINE KAYE (FNP)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:KAYE
Last Name:DANGERFIELD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6701 BAUM DR
Mailing Address - Street 2:STE 140
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7360
Mailing Address - Country:US
Mailing Address - Phone:865-584-5727
Mailing Address - Fax:865-450-9904
Practice Address - Street 1:11416 GRIGSBY CHAPEL RD
Practice Address - Street 2:STE 103
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1770
Practice Address - Country:US
Practice Address - Phone:865-966-2688
Practice Address - Fax:865-777-0613
Is Sole Proprietor?:No
Enumeration Date:2015-12-29
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN21082363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner