Maddox, Christine Marie

Maddox, Christine Marie is an individual health care provider with primary practice located at 8865 W 400 N Ste 120 , Michigan City IN 46360-9011. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Maddox, Christine Marie can be contacted via phone (219) 878-5031.

Contact Information

Primary practice address
8865 W 400 N Ste 120 Michigan City IN 46360-9011
Phone: (219) 878-5031
Fax: (219) 879-5498
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71001740A Indiana

Profile Details

NPI number 1063483642
LBN Legal business name Maddox, Christine Marie
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2006
Last updated Oct 11th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063483642 NPPES
Indiana Other M400035552 MEDICARE PTAN
Indiana MEDICAID 201007040 MEDICARE PTAN
Indiana Other 000001078424 MEDICARE PTAN

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