Provider Demographics
NPI:1629857651
Name:GOLDSTONE, MADELEINE JOELLE (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:MADELEINE
Middle Name:JOELLE
Last Name:GOLDSTONE
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3193 HOWELL MILL RD NW STE 250
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-2129
Mailing Address - Country:US
Mailing Address - Phone:706-993-6518
Mailing Address - Fax:404-351-3515
Practice Address - Street 1:3193 HOWELL MILL RD NW STE 250
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2129
Practice Address - Country:US
Practice Address - Phone:706-993-6518
Practice Address - Fax:404-351-3515
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA279390363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics