Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 5007711 | NC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 20563 | SC |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 236796 | GA |
NPI | 1003298274 |
---|---|
Provider Name | Ashley Nix |
First Address | North Augusta, SC 29841-3849 |
Second Address | Evans, GA 30809-3091 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2015 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20563 | APRN SC (01) | SC |
236796 | GEORGIA APRN (01) | GA |
5007711 | NURSE PRACTITIONER LICENSE (01) | NC |