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General NPI Number Information
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NPI Number | 1154595304
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Entity Type | Individual
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Provider Name | MARANDA NICOLE MCCRAY-DIXON RN
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Gender | Female
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 03/25/2026
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Provider Practice Location Address
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Address Line | 701 SENECA ST STE 646C
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City | BUFFALO
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State | NY
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Zip | 14210-1351
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Country | US
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Telephone | 716-995-4450
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Fax |
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Provider Business Mailing Address
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Address Line | 715 DELAWARE AVE APT 715
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City | BUFFALO
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State | NY
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Zip | 14209-2212
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Country | US
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Telephone | 716-884-7640
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP018843
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 590837
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AC006592
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0024183335
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95006438
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | LP-0010770
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License Number State | DE
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