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Detra K Dixon, FNP
Family Nurse Practitioner in Macon, Georgia
NPI 1376101196

Detra K Dixon is a Family Nurse Practitioner based in Macon, GA and is specialized in Family. Detra K Dixon practices in Macon, GA and has the professional credentials of FNP. The NPI Number for Detra K Dixon is 1376101196 and holds a License No. RN213793 (Georgia).

The current practice location address for Detra K Dixon is 227 Amalie Dr, Macon, GA and can be reached out via phone at 478-731-9521.

Location: 227 Amalie Dr, Macon, GA, 31220-2667
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1376101196
Provider Name
Detra K Dixon
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
227 Amalie Dr, Macon, GA, 31220-2667
Phone Number
478-731-9521
Fax Number
Provider Enumeration Date
06/05/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
RN213793 01 GA NP LICENSING NUMBER
institution
Provider Business Practice Location Address Details
Address
227 Amalie Dr
City
Macon
State
Georgia
Zip
31220-2667
Phone Number
478-731-9521
Fax Number
person
Provider Business Mailing Address Details
Address
227 Amalie Dr
City
Macon
State
Georgia
Zip
31220-2667
Phone Number
478-731-9521
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
RN213793 (Georgia)
Definition
Definition to come...
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