Provider Demographics
NPI:1700672029
Name:SLATON, MADALYN
Entity type:Individual
Prefix:
First Name:MADALYN
Middle Name:
Last Name:SLATON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 DAWSON MANOR CT
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-6030
Mailing Address - Country:US
Mailing Address - Phone:770-561-2489
Mailing Address - Fax:
Practice Address - Street 1:108 PROMINENCE CT STE 100
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-6340
Practice Address - Country:US
Practice Address - Phone:706-344-6950
Practice Address - Fax:706-344-6951
Is Sole Proprietor?:No
Enumeration Date:2025-04-15
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN300050363LF0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program