Provider Demographics
NPI:1891552543
Name:JOLLIFF, MADISON ANNETTE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:ANNETTE
Last Name:JOLLIFF
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:MADISON
Other - Middle Name:ANNETTE
Other - Last Name:EMERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 10597
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78766-1597
Mailing Address - Country:US
Mailing Address - Phone:512-485-5889
Mailing Address - Fax:512-420-0397
Practice Address - Street 1:1180 SETON PKWY STE 410
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6184
Practice Address - Country:US
Practice Address - Phone:512-504-0057
Practice Address - Fax:512-504-0072
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1153012363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner