Healthcare Provider Details

I. General information

NPI: 1013476597
Provider Name (Legal Business Name): ALECIA G DIXON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 03/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6444 BEACH BLVD
JACKSONVILLE FL
32216-2891
US

IV. Provider business mailing address

6444 BEACH BLVD
JACKSONVILLE FL
32216-2891
US

V. Phone/Fax

Practice location:
  • Phone: 904-805-9600
  • Fax: 904-805-0084
Mailing address:
  • Phone: 904-805-9600
  • Fax: 904-805-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP11001804
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: