Individual
NICHOLAS MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
540 WAUGH ST, JEFFERSON, NC 28640-9034
(336) 246-5581
Mailing address
389 FALLS DR NW, ABINGDON, VA 24210-8093
(276) 623-0740
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5021560
NC
363LP2300X
Primary Care Nurse Practitioner
0024185720
VA
Other
Enumeration date
11/07/2022
Last updated
04/12/2025
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