Doctor Name: | MRS. CHARLENE L MADDOX |
NPI Number: | 1023335833 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 1045879 |
Business Practice Address: | 163 Tower Cir Somerset, KY - 425033479 |
Business Phone Number: | 6066760786 |
Business Fax Number: | 6064510446 |
Mailing Address: | 4330 Lebanon Rd, DANVILLE |
State: | KY |
Postal Code: | 404229626 |
Phone Number: | 6066760786 |
Fax Number: | 6064510446 |
NPI Enumeration Date: | 05/03/2010 |
NPI Last Update Date: | 05/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP2201X |
License Number: | 1045879 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Ambulatory Care |
Taxonomy Definition: |