Doctor Name: | KEZIA NIXON |
NPI Number: | 1194053595 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | 4053 |
Business Practice Address: | 30 Mauser Dr Lugoff, SC - 290788632 |
Business Phone Number: | 7017413784 |
Business Fax Number: | |
Mailing Address: | 30 Mauser Dr, LUGOFF |
State: | SC |
Postal Code: | 290788632 |
Phone Number: | 7017413784 |
Fax Number: | |
NPI Enumeration Date: | 11/23/2009 |
NPI Last Update Date: | 12/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4053 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |