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NPI Code Detail

MEDICARE: DR. BRIENNA NIXON PT, DPT, OCS

MEDICARE: DR. BRIENNA NIXON PT, DPT, OCS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist12801-24WI

General Provider Information

NPI Number : 1093123150
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIENNA NIXON PT, DPT, OCS
Provider Business Mailing Address
First Line : 101 BODIN CIR
Second Line :
City : TRAVIS AFB
State : CA
Zip : 94535-1809
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6011 N ORACLE RD STE 151
Second Line :
City : TUCSON
State : AZ
Zip : 85704-5309
Country : US
Telephone Number : 520-561-0101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2014
Last Update Date : 08/28/2023

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