Maddox, Mary

Maddox, Mary is an individual health care provider with primary practice located at 13123 E 16Th Ave , Aurora CO 80045-7106. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Maddox, Mary can be contacted via phone (720) 777-1234.

Contact Information

Primary practice address
13123 E 16Th Ave Aurora CO 80045-7106
Phone: (720) 777-1234
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 128803 Colorado

Profile Details

NPI number 1043395783
LBN Legal business name Maddox, Mary
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2006
Last updated Oct 26th, 2012 - about 13 years ago

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 1043395783 NPPES
Colorado MEDICAID 66100577

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