Provider Demographics
NPI:1730058801
Name:MIDDLETON, MACIE KAYE (FNP-C)
Entity type:Individual
Prefix:
First Name:MACIE
Middle Name:KAYE
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 STARLING ST STE 404
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4269
Mailing Address - Country:US
Mailing Address - Phone:912-466-7660
Mailing Address - Fax:
Practice Address - Street 1:2500 STARLING ST STE 404
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4269
Practice Address - Country:US
Practice Address - Phone:912-466-7660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPRN-NP303648207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease