Individual
MRS. DIXIE STORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CM
Contact information
Practice address
6103 JUDSON AVE, LAS VEGAS, NV 89156-5821
(702) 453-3299
(702) 452-0384
Mailing address
6103 JUDSON AVE, LAS VEGAS, NV 89156-5821
(702) 453-3299
(702) 452-0384
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary
602
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
667411
PREFERRED PROVIDER ID #
NV
Enumeration date
05/23/2007
Last updated
07/08/2007
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