Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 600779 | TX |
NPI | 1053457788 |
---|---|
Provider Name | Mrs. Suzanne Atkinson Dillon |
First Address | Dallas, TX 75231-4534 |
Second Address | Dallas, TX 75231-4534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 08/07/2007 |