Individual
MR. DYLAN KEITH MIXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
704 BREEDLOVE DR STE A, MONROE, GA 30655-2054
(888) 772-0076
(770) 751-8014
Mailing address
18 FERN PARK LN, DAWSONVILLE, GA 30534-8417
(706) 248-0993
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN248478
GA
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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