Provider Demographics
NPI:1245779974
Name:MADSEN, ANN B (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:B
Last Name:MADSEN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:778 N DEAN RD STE 300
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-4315
Mailing Address - Country:US
Mailing Address - Phone:251-610-0296
Mailing Address - Fax:334-460-0468
Practice Address - Street 1:778 N DEAN RD STE 300
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-4315
Practice Address - Country:US
Practice Address - Phone:334-219-0425
Practice Address - Fax:334-460-0468
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-135788363LP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse