Healthcare Provider Details

I. General information

NPI: 1174485031
Provider Name (Legal Business Name): DESTINY PARKER-NIXON DPT, PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3322 VILLAGE RD
ROCKY MOUNT NC
27804-9593
US

IV. Provider business mailing address

3322 VILLAGE RD
ROCKY MOUNT NC
27804-9593
US

V. Phone/Fax

Practice location:
  • Phone: 252-442-4156
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: