Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 21082 | TN |
NPI | 1003271529 |
---|---|
Provider Name | Madeline Kaye Dangerfield |
First Address | Knoxville, TN 37919-7360 |
Second Address | Knoxville, TN 37934-1770 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2015 |
Last Update Date | 11/05/2021 |