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Individual

MR. DANNIE LAINE MADDOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RNP

Contact information

Practice address
2200 FORT ROOTS DR, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-3185
(510) 257-2835
Mailing address
4624 CRESTLINE DR, NORTH LITTLE ROCK, AR 72116-7441
(501) 912-4383
(501) 257-2835

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
P01046
AR

Other

Enumeration date
08/10/2006
Last updated
07/08/2007
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