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Individual
MR. KEVIN O MIXON
Active
Individual
MR. KEVIN O MIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP03979
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2142348
—
LA
01
—
P01359174
MEDICARE RR
LA
Enumeration date
02/09/2009
Last updated
12/29/2022
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