Doctor Name: | AMY J DIX |
NPI Number: | 1023396900 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | SP011508 |
Business Practice Address: | 1720 Highway 59 S Thief River Falls, MN - 567014331 |
Business Phone Number: | 2186814747 |
Business Fax Number: | |
Mailing Address: | 1720 Highway 59 S, THIEF RIVER FALLS |
State: | MN |
Postal Code: | 567014331 |
Phone Number: | 2186814747 |
Fax Number: | |
NPI Enumeration Date: | 07/27/2011 |
NPI Last Update Date: | 07/31/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP011508 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |