Doctor Name: | MARY DIXON |
NPI Number: | 1083038541 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SP013468 |
Business Practice Address: | 1211 Forge Rd Ste 300 Carlisle, PA - 170133183 |
Business Phone Number: | 7172183920 |
Business Fax Number: | 7172183921 |
Mailing Address: | 205 Grandview Ave, CAMP HILL |
State: | PA |
Postal Code: | 170111708 |
Phone Number: | 7179724480 |
Fax Number: | 7179724656 |
NPI Enumeration Date: | 02/04/2014 |
NPI Last Update Date: | 02/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | SP013468 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |