Individual
AKELA DIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
52 4TH ST, DEPOSIT, NY 13754-1024
(607) 621-9175
Mailing address
52 4TH ST, DEPOSIT, NY 13754-1024
(607) 621-9175
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
330063
NY
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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