Healthcare Provider Details

I. General information

NPI: 1114085834
Provider Name (Legal Business Name): JENNEFER DORIS DIXON NP-C, FNP, MSN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 HOSPITAL DR. SUITE 500
CARTHAGE TN
37030
US

IV. Provider business mailing address

133 HOSPITAL DR. SUITE 500
CARTHAGE TN
37030
US

V. Phone/Fax

Practice location:
  • Phone: 615-735-0700
  • Fax: 615-735-5480
Mailing address:
  • Phone: 615-735-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12396
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number141259
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: