Healthcare Provider Details

I. General information

NPI: 1497308316
Provider Name (Legal Business Name): LINDSEY HIXON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2019
Last Update Date: 01/09/2020
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 COLLIER RD NW
ATLANTA GA
30309-1796
US

IV. Provider business mailing address

2318 OAKTON PL SE
SMYRNA GA
30082-5255
US

V. Phone/Fax

Practice location:
  • Phone: 404-574-5820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF11180513
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: