Individual
CASEY DIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
23 W MARTIN LUTHER KING JR BLVD, MC RAE, GA 31055-4150
(229) 947-4071
Mailing address
PO BOX 692, OCILLA, GA 31774-0692
(229) 425-2539
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN220968
GA
Other
Enumeration date
05/14/2020
Last updated
05/18/2020
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