Healthcare Provider Details

I. General information

NPI: 1437669710
Provider Name (Legal Business Name): HAMNET SUSANNAH DIXON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2017
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2500
STAUNTON VA
24402-2500
US

IV. Provider business mailing address

159 TURKEY TROT LN
ZION CROSSROADS VA
22942-6997
US

V. Phone/Fax

Practice location:
  • Phone: 540-332-8001
  • Fax:
Mailing address:
  • Phone: 540-414-4138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024175326
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: