Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | ARNP11001804 | FL |
NPI | 1013476597 |
---|---|
Provider Name | Alecia G Dixon |
First Address | Jacksonville, FL 32216-2891 |
Second Address | Jacksonville, FL 32216-2891 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2019 |
Last Update Date | 14/03/2019 |