Healthcare Provider Details

I. General information

NPI: 1205551447
Provider Name (Legal Business Name): BARBARA ANN DIXON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1331 MOUNT ZION RD
MORROW GA
30260-2357
US

IV. Provider business mailing address

1395 NW 167TH ST
MIAMI GARDENS FL
33169-5710
US

V. Phone/Fax

Practice location:
  • Phone: 770-629-3217
  • Fax: 404-666-0085
Mailing address:
  • Phone: 305-628-6117
  • Fax: 305-393-5989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP197568
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: