Healthcare Provider Details

I. General information

NPI: 1669760054
Provider Name (Legal Business Name): KERRI A. NIXON N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2011
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 E ROBINSON RD STE 205
WEST AMHERST NY
14228-2044
US

IV. Provider business mailing address

3950 E ROBINSON RD STE 205
WEST AMHERST NY
14228-2044
US

V. Phone/Fax

Practice location:
  • Phone: 716-691-3400
  • Fax:
Mailing address:
  • Phone: 716-691-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF382224-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: