Individual
ATHENA L NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
4441 E KINGS CANYON RD, FRESNO, CA 93702-3604
(559) 978-2428
Mailing address
4441 E KINGS CANYON RD, FRESNO, CA 93702-3604
(559) 978-2428
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
726394
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164X00000X
—
CA
Enumeration date
07/26/2022
Last updated
08/02/2022
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