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Individual

MRS. RHONDA WALLACE DIXON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHNP

Contact information

Practice address
4130 CLEMMONS RD, CLEMMONS, NC 27012-7520
(336) 765-5470
(336) 499-5428
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 316-4979
(704) 316-4978

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
940015
NC
363LW0102X
Women's Health Nurse Practitioner
940015
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7005570
NC
Enumeration date
03/20/2007
Last updated
10/04/2023
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