Healthcare Provider Details

I. General information

NPI: 1083540801
Provider Name (Legal Business Name): MELISSA ANN MADDOX RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 11TH AVE S STE 400
BIRMINGHAM AL
35205-3423
US

IV. Provider business mailing address

225 HONEY COVE WAY
TRUSSVILLE AL
35173-4393
US

V. Phone/Fax

Practice location:
  • Phone: 205-930-8300
  • Fax: 205-930-8301
Mailing address:
  • Phone: 850-485-8535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License Number1-176451
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: