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Organization
SHANDA SOUTHARD DIXON
Active
Organization
SHANDA SOUTHARD DIXON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANDA DIXON NP-C (NURSE PRACTITIONER)
(270) 827-7200
Entity
Organization
Contact information
Practice address
1305 N ELM ST, HENDERSON, KY 42420-2783
(270) 827-7200
Mailing address
1305 S ELM ST, HENDERSON, KY 42420-4310
(270) 827-7200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007749
KY
Other
Enumeration date
10/25/2012
Last updated
05/06/2013
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