Individual
AMANDA JEAN MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
511 STATE HIGHWAY 59 N, SUMMERDALE, AL 36580-3686
(251) 989-9400
Mailing address
PO BOX 703, SUMMERDALE, AL 36580-0703
(251) 989-9400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1-150202
AL
363L00000X
Nurse Practitioner
Primary
1-150202
AL
Other
Enumeration date
12/16/2020
Last updated
10/18/2022
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