Provider Demographics
NPI:1154157998
Name:MADDUX, DAWN ELIZABETH (MPH, BSN, RN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:ELIZABETH
Last Name:MADDUX
Suffix:
Gender:F
Credentials:MPH, BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:597 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-2757
Mailing Address - Country:US
Mailing Address - Phone:615-424-3296
Mailing Address - Fax:
Practice Address - Street 1:597 POPLAR ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-2757
Practice Address - Country:US
Practice Address - Phone:615-424-3296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC242815163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant