MEDICARE: KATHERINE C DIXON NP

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
1	363LF0000X	Family Nurse Practitioner	213963	LA

General Provider Information

NPI Number	:	1194341735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE C DIXON NP

Provider Business Mailing Address
First Line	:	275 HODGE WATSON RD
Second Line	:
City	:	CALHOUN
State	:	LA
Zip	:	71225-8187
Country	:	US
Telephone Number	:	318-372-1276
Fax Number	:

Provider Business Practice Location Address
First Line	:	1613 LOUISVILLE AVE
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-6027
Country	:	US
Telephone Number	:	318-855-3291
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2020
Last Update Date	:	06/24/2024

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