Maddox, Magan

Maddox, Magan is an individual health care provider with primary practice located at 985 Taylor St Sw , Conyers GA 30012-5357. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Maddox, Magan can be contacted via phone (770) 785-4345.

Contact Information

Primary practice address
985 Taylor St Sw Conyers GA 30012-5357
Phone: (770) 785-4345
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 078164 Georgia

Profile Details

NPI number 1396093282
LBN Legal business name Maddox, Magan
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2012
Last updated Aug 27th, 2012 - about 14 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 1396093282 NPPES
Georgia MEDICAID 000456486A

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