Provider Demographics
NPI:1437843950
Name:METZMEIER, MADISON (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:
Last Name:METZMEIER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:MADISON
Other - Middle Name:
Other - Last Name:TANK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:306 W ASH RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-3904
Mailing Address - Country:US
Mailing Address - Phone:678-628-6578
Mailing Address - Fax:
Practice Address - Street 1:52 W SHIRLEY AVE
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3008
Practice Address - Country:US
Practice Address - Phone:540-347-9220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant