Provider Demographics
NPI:1841374527
Name:USHER, MADELINE M (RN, NP)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:M
Last Name:USHER
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W 3RD AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1985
Mailing Address - Country:US
Mailing Address - Phone:229-312-7000
Mailing Address - Fax:229-312-7004
Practice Address - Street 1:500 W 3RD AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1985
Practice Address - Country:US
Practice Address - Phone:229-312-7000
Practice Address - Fax:229-312-7004
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN167457364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAQ11207Medicare UPIN
GA89BBBHKMedicare ID - Type UnspecifiedPART B PROVIDER NUMBER
GARN167457OtherGA STATE LICENSE NUMBER