Provider Demographics
NPI:1922336379
Name:MADDOX, JAMILA KIANGA
Entity type:Individual
Prefix:MRS
First Name:JAMILA
Middle Name:KIANGA
Last Name:MADDOX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3559 READING RD STE 103
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2689
Mailing Address - Country:US
Mailing Address - Phone:513-376-3996
Mailing Address - Fax:513-242-2296
Practice Address - Street 1:881 W NORTH BEND RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-1340
Practice Address - Country:US
Practice Address - Phone:513-242-2888
Practice Address - Fax:513-242-2296
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker