Individual
KRISTINA MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
304 TURNER MCCALL BLVD SW, ROME, GA 30165-5621
(706) 509-5000
Mailing address
PO BOX 2704, ROME, GA 30164-2704
(706) 291-0291
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN176279
GA
Other
Enumeration date
11/01/2019
Last updated
10/24/2021
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