Provider Demographics
NPI:1003689225
Name:MADDEN, ERIN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:MADDEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 JOHN INGRAM RD SE
Mailing Address - Street 2:
Mailing Address - City:SILVER CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30173-3700
Mailing Address - Country:US
Mailing Address - Phone:706-266-9743
Mailing Address - Fax:
Practice Address - Street 1:1280 MAULDIN RD NW
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-8615
Practice Address - Country:US
Practice Address - Phone:706-625-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GANCO-000003363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily