Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | APRN9247639 | FL |
NPI | 1003302589 |
---|---|
Provider Name | Mendi Taylor Nixon |
First Address | Orlando, FL 32804-1330 |
Second Address | Orlando, FL 32808-5646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2018 |
Last Update Date | 22/10/2021 |