Provider Demographics
NPI:1982818514
Name:MADDOX, CATHERINE ANNE (LPN)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ANNE
Last Name:MADDOX
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:ANNE
Other - Last Name:LINDLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:2005 WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-1132
Mailing Address - Country:US
Mailing Address - Phone:405-525-2525
Mailing Address - Fax:
Practice Address - Street 1:1215 NW 25TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-5629
Practice Address - Country:US
Practice Address - Phone:405-525-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL0033171164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse