Individual
DEIDRE NIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4114 MARTIN AVE, TIFTON, GA 31794-6121
(229) 339-1877
Mailing address
4114 MARTIN AVE, TIFTON, GA 31794-6121
(229) 339-1877
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
11/30/2016
Last updated
11/30/2016
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