Doctor Name: | SUE LILLIAN DIXON |
NPI Number: | 1184055931 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | WHNP-B.C. |
License Number: | 086006332N7 |
Business Practice Address: | 715 S.w. 4th St. Ste.c Madras, OR - 97741 |
Business Phone Number: | 5414754456 |
Business Fax Number: | 5414750132 |
Mailing Address: | 715 S.w. 4th St., Ste.c MADRAS |
State: | OR |
Postal Code: | 97741 |
Phone Number: | 5414754456 |
Fax Number: | 5414750132 |
NPI Enumeration Date: | 12/04/2013 |
NPI Last Update Date: | 12/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | 086006332N7 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |