Individual
NICOLE MONIQUE MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6559 WILSON MILLS RD STE 106, CLEVELAND, OH 44143
(440) 449-1540
Mailing address
PO BOX 931596, CLEVELAND, OH 44193-1724
(440) 449-1540
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN.CNP.025956
OH
363LA2100X
Acute Care Nurse Practitioner
Primary
2021182892
OH
363LP2300X
Primary Care Nurse Practitioner
10190061
OH
363LP2300X
Primary Care Nurse Practitioner
RN.339635
OH
Other
Enumeration date
12/23/2021
Last updated
05/02/2024
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