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Individual
DIXIE STILES
Active
Individual
DIXIE STILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
508290
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912919804
NPI - TYPE 2
—
01
—
CG5665
RAIL ROAD MEDICARE - GROUP PTAN
CA
01
—
P00140070
RAIL ROAD MEDICARE - PROVIDER PTAN
CA
01
—
W1514
MEDICARE PTAN - TYPE 2
CA
Enumeration date
03/16/2006
Last updated
02/23/2015
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