Provider Demographics
NPI:1083474613
Name:MAUGHON, ADRIENNE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:MAUGHON
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:MARY
Other - Last Name:QUINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30549-6333
Mailing Address - Country:US
Mailing Address - Phone:706-714-0645
Mailing Address - Fax:706-703-1306
Practice Address - Street 1:240 MITCHELL BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2043
Practice Address - Country:US
Practice Address - Phone:706-369-5745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN286137163WP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health