Provider Demographics
NPI:1619427440
Name:STOFFER, MADELINE LANGENFELDER (FNP)
Entity Type:Individual
Prefix:
First Name:MADELINE
Middle Name:LANGENFELDER
Last Name:STOFFER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5873 BRENTWOOD TRCE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4658
Mailing Address - Country:US
Mailing Address - Phone:901-497-2185
Mailing Address - Fax:
Practice Address - Street 1:1418 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3380
Practice Address - Country:US
Practice Address - Phone:615-453-7720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21897363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily