MEDICARE: MRS. DEBORAH ANN DIX CRNP

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	163WW0101X	Ambulatory Women's Health Care Registered Nurse	SP001641G	PA

General Provider Information

NPI Number	:	1871818039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH ANN DIX CRNP

Provider Business Mailing Address
First Line	:	ONE MEDICAL CENTER BLVD.
Second Line	:	CROZER CHESTER MEDICAL CENTER,PEARL HALL BUILDING,
City	:	UPLAND
State	:	PA
Zip	:	19013-3995
Country	:	US
Telephone Number	:	610-447-2200
Fax Number	:	610-447-2215

Provider Business Practice Location Address
First Line	:	ONE MEDICAL CENTER BLVD.
Second Line	:	CROZER CHESTER MEDICAL CENTER,PEARL HALL BUILDING,
City	:	UPLAND
State	:	PA
Zip	:	19013-3995
Country	:	US
Telephone Number	:	610-447-2200
Fax Number	:	610-447-2215

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

Provider Enumeration Date	:	03/31/2010
Last Update Date	:	03/31/2010

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