Healthcare Provider Details

I. General information

NPI: 1801075981
Provider Name (Legal Business Name): DIXIE DIANE BURCHFIELD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4098 ADAMS ST
CUMMING IA
50061-5609
US

IV. Provider business mailing address

3007 PROSPECT DR
DES MOINES IA
50310-5218
US

V. Phone/Fax

Practice location:
  • Phone: 515-981-5926
  • Fax: 515-981-5934
Mailing address:
  • Phone: 515-274-0272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number034904
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: