KELLI GREGG MADDOX

COLUMBIA, SC
NPI1013584341
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: SC  25503)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-06-07
Last Update Date2022-01-13
Business Address
KELLI GREGG MADDOX
1601 GREENE ST
COLUMBIA, SC 29208-4001
Phone number: 803-777-7412
Mailing Address
KELLI GREGG MADDOX
PO BOX 751461
CHARLOTTE, NC 28275-1461
Phone number: 843-792-6200