Healthcare Provider Details

I. General information

NPI: 1629526959
Provider Name (Legal Business Name): LINDSEY ANNE DIXON BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDSEY ANNE COX

II. Dates (important events)

Enumeration Date: 09/15/2016
Last Update Date: 09/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 NE EVANS ST
MCMINNVILLE OR
97128-3923
US

IV. Provider business mailing address

627 NE EVANS ST
MCMINNVILLE OR
97128-3923
US

V. Phone/Fax

Practice location:
  • Phone: 503-474-6293
  • Fax:
Mailing address:
  • Phone: 503-474-6293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number201606809RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: