Kelli Gregg Maddox
NPI #1013584341 in Columbia, South Carolina
Provider Information
- NPI Number
- 1013584341
- Entity Type
- Individual
- Name
- Kelli Gregg Maddox
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- Jun 7, 2021
- Last Updated
- Jan 13, 2022
Practice Location
- Address
- 1601 GREENE ST
- City
- Columbia
- State
- South Carolina
- ZIP Code
- 29208-4001
- Phone
- (803) 777-7412
Specialties & Taxonomy Codes
| Specialty |
|---|
| Student in an Organized Health Care Education/Training Program |
| Nurse Practitioner |
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