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General NPI Number Information
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NPI Number | 1447191457
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Entity Type | Individual
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Provider Name | GEORGETTA L MADDOX BSN/RN
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Gender | Female
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 814 N 26TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53233-1508
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Country | US
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Telephone | 414-207-4560
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Fax | 414-448-6946
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Provider Business Mailing Address
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Address Line | 814 N 26TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53233-1508
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Country | US
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Telephone | 414-207-4560
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Fax | 414-448-6946
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 264448-30
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 163WP0000X
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Taxonomy Name | Pain Management Registered Nurse
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License Number | 264448-30
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 163WC1600X
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Taxonomy Name | Continuing Education/Staff Development Registered Nurse
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License Number | 264448-30
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 264448-30
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License Number State | WI
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Taxonomy #5
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 264448-30
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1265
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License Number State | WI
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Taxonomy #7
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 264448-30
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License Number State | WI
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Taxonomy #8
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Taxonomy Code | 163WR0400X
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Taxonomy Name | Rehabilitation Registered Nurse
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License Number | 264448-30
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License Number State | WI
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Taxonomy #9
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 264448-30
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License Number State | WI
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Taxonomy #10
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Taxonomy Code | 163WX0106X
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Taxonomy Name | Occupational Health Registered Nurse
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License Number | 264448-30
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License Number State | WI
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Taxonomy #11
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 1265
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License Number State | WI
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