Provider Demographics
NPI:1538758040
Name:MITCHELL, MADISON MILLER (APRN)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:MILLER
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:ELIZABETH
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100225
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0225
Mailing Address - Country:US
Mailing Address - Phone:352-273-8737
Mailing Address - Fax:352-273-9154
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-1885
Practice Address - Country:US
Practice Address - Phone:352-273-8737
Practice Address - Fax:352-273-9154
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5015415363L00000X
FLAPRN11023529363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner