Provider Demographics
NPI:1013409978
Name:WEBB, MADISON BAILEY (APRN)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:BAILEY
Last Name:WEBB
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:BAILEY
Other - Last Name:LIND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6803 MILLIKIN CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2245
Mailing Address - Country:US
Mailing Address - Phone:512-694-4263
Mailing Address - Fax:
Practice Address - Street 1:12200 RENFERT WAY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5653
Practice Address - Country:US
Practice Address - Phone:512-533-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137338363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health