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1124039078
DANNIE LAINE MADDOX
NORTH LITTLE ROCK, AR
NPI
1124039078
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: AR P01046)
Enumeration Date
2006-08-10
Last Update Date
2007-07-08
Business Address
Mr. DANNIE LAINE MADDOX RNP
2200 FORT ROOTS DR
NORTH LITTLE ROCK, AR 72114-1709
Phone number: 501-257-3185
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Mailing Address
Mr. DANNIE LAINE MADDOX RNP
4624 CRESTLINE DR
NORTH LITTLE ROCK, AR 72116-7441
Phone number: 501-912-4383
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