Doctor Name: | GINA H MIXON |
NPI Number: | 1902807720 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | D0722 |
Business Practice Address: | 1220 Jefferson St Laurel, MS - 394404355 |
Business Phone Number: | 6014264086 |
Business Fax Number: | 6014264417 |
Mailing Address: | 11 Place Road, ELLISVILLE |
State: | MS |
Postal Code: | 39437 |
Phone Number: | 6014264086 |
Fax Number: | 6014264417 |
NPI Enumeration Date: | 08/02/2005 |
NPI Last Update Date: | 11/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | D0722 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |