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General NPI Number Information
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NPI Number | 1255593364
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Entity Type | Individual
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Provider Name | TAMMY LOFTON DIXON FNP
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Gender | Female
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 427 HIGHWAY 51 N
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City | BROOKHAVEN
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State | MS
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Zip | 39601-2350
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Country | US
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Telephone | 601-835-9165
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Fax | 601-835-9164
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Provider Business Mailing Address
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Address Line | 174 SPRINGFIELD TRL SW
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City | BOGUE CHITTO
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State | MS
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Zip | 39629-8209
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Country | US
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Telephone | 601-757-1296
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R858704
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | R858704
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License Number State | MS
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