Individual
JADE GB DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6919 E 10TH ST STE E1A, INDIANAPOLIS, IN 46219-4892
(463) 206-2120
(317) 222-6896
Mailing address
1257 SCHLEICHER AVE, INDIANAPOLIS, IN 46229-2330
(317) 702-7416
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28238155A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28238155A
REGISTERED NURSE
IN
01
—
28238155C
COMPACT REGISTERED NURSE
IN
Enumeration date
04/06/2022
Last updated
04/06/2022
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