Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | 5010302 | NC |
Y | 363L00000X | Nurse Practitioner | 5010302 | NC |
NPI | 1023518909 |
---|---|
Provider Name | Stephanie Nicole Dixon |
First Address | High Point, NC 27265-9293 |
Second Address | Greensboro, NC 27401-1004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2018 |
Last Update Date | 17/09/2021 |