Provider Demographics
NPI:1164211710
Name:DESKINS, MADISON (APRN-CNP)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:DESKINS
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 OVERTON PARK DR W
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-1903
Mailing Address - Country:US
Mailing Address - Phone:612-388-0955
Mailing Address - Fax:
Practice Address - Street 1:3418 N TARRANT PKWY STE 310
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76177-8645
Practice Address - Country:US
Practice Address - Phone:817-562-2339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1193640207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine