Individual
MANDIE L MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2855 MILLER DR STE 205, PLYMOUTH, IN 46563-8093
(574) 941-1080
Mailing address
16597 18B RD, CULVER, IN 46511-9733
(574) 339-6072
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28185360A
IN
Other
Enumeration date
05/25/2024
Last updated
07/19/2024
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