Healthcare Provider Details

I. General information

NPI: 1770964637
Provider Name (Legal Business Name): DR. ELLEN DIXON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2015
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 SNYDER DR
ROCHESTER PA
15074-2708
US

IV. Provider business mailing address

145 SNYDER DR
ROCHESTER PA
15074-2708
US

V. Phone/Fax

Practice location:
  • Phone: 724-448-8923
  • Fax:
Mailing address:
  • Phone: 724-448-8923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP447538
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: