Provider Demographics
NPI:1023346004
Name:MADDUX, WENDY LOU (APRN)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:LOU
Last Name:MADDUX
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 NE MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-4000
Mailing Address - Country:US
Mailing Address - Phone:406-350-4067
Mailing Address - Fax:
Practice Address - Street 1:408 WENDELL AVE
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-2261
Practice Address - Country:US
Practice Address - Phone:406-535-6302
Practice Address - Fax:406-535-6306
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-178764364S00000X
MT178764363LG0600X
MTRN25056163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163WW0000XNursing Service ProvidersRegistered NurseWound Care