Healthcare Provider Details
I. General information
NPI: 1295541324
Provider Name (Legal Business Name): BRETT EUGENE DIXON
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/04/2024
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER COLLEGE OF NURSING 874 UNION AVE RM 325
MEMPHIS TN
38163
US
IV. Provider business mailing address
UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER COLLEGE OF NURSING 874 UNION AVE RM 325
MEMPHIS TN
38163
US
V. Phone/Fax
- Phone: 901-448-6128
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: