Individual
JANE CHRISTINE MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2307 LAPORTE AVE STE 8, VALPARAISO, IN 46383-6997
(219) 464-7073
(219) 464-7543
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
111346
NE
363LF0000X
Family Nurse Practitioner
Primary
71001250A
IN
Other
Enumeration date
08/05/2006
Last updated
07/15/2021
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