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General NPI Number Information
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NPI Number | 1154446888
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Entity Type | Individual
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Provider Name | RHONDA WALLACE DIXON WHNP
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Gender | Female
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 4130 CLEMMONS RD
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City | CLEMMONS
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State | NC
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Zip | 27012-7520
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Country | US
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Telephone | 336-765-5470
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Fax | 336-499-5428
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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Country | US
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Telephone | 704-316-4979
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Fax | 704-316-4978
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 940015
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 940015
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License Number State | NC
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