Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AC003270 | MD |
NPI | 1275146417 |
---|---|
Provider Name | Dr. Kristi Lynn Dixon |
First Address | Camp Lejeune, NC 28547-2575 |
Second Address | Camp Lejeune, NC 28547-2575 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2020 |
Last Update Date | 27/08/2020 |