Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 023513 | OH |
NPI | 1063995264 |
---|---|
Provider Name | Mrs. Katherine Anna Nixon |
First Address | Carrollton, OH 44615-9300 |
Second Address | Canton, OH 44708-4698 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2018 |
Last Update Date | 13/09/2018 |