Provider Demographics
NPI:1902390636
Name:YANCEY, MADISON ALEXANDRIA (FNP)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:ALEXANDRIA
Last Name:YANCEY
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 1:8225 MEMPHIS ARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-2103
Mailing Address - Country:US
Mailing Address - Phone:901-826-6540
Mailing Address - Fax:
Practice Address - Street 1:1417 MONROE AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3634
Practice Address - Country:US
Practice Address - Phone:901-272-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-16
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000207646163W00000X
TN0000034190207Q00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine