Provider Demographics
NPI:1790664969
Name:MADDOX-COLE, AUDREY ABIGAIL
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:ABIGAIL
Last Name:MADDOX-COLE
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 1:23 CHURCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:DIXMONT
Mailing Address - State:ME
Mailing Address - Zip Code:04932-3500
Mailing Address - Country:US
Mailing Address - Phone:207-930-0282
Mailing Address - Fax:
Practice Address - Street 1:23 CHURCH HILL RD
Practice Address - Street 2:
Practice Address - City:DIXMONT
Practice Address - State:ME
Practice Address - Zip Code:04932-3500
Practice Address - Country:US
Practice Address - Phone:207-930-0282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program