Individual
MANDI M DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5312 HEIDI LN, BREWERTON, NY 13029-9787
(315) 668-0323
Mailing address
5312 HEIDI LN, BREWERTON, NY 13029-9787
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
535402
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02709355
—
NY
Enumeration date
11/17/2007
Last updated
11/17/2007
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