Healthcare Provider Details

I. General information

NPI: 1770003097
Provider Name (Legal Business Name): NANCY DIXON SELLARS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5430 BOWMAN RD
MACON GA
31210-8879
US

IV. Provider business mailing address

PO BOX 749495
ATLANTA GA
30374-9495
US

V. Phone/Fax

Practice location:
  • Phone: 478-743-7068
  • Fax: 478-741-1354
Mailing address:
  • Phone: 855-963-2100
  • Fax: 813-321-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN203018
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: