Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 200850050NP | OR |
NPI | 1245499383 |
---|---|
Provider Name | Tamara Louise Dixon |
First Address | Medford, OR 97504 |
Second Address | Medford, OR 97504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2008 |
Last Update Date | 21/03/2013 |