=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710448253
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDIA BATTEN DIXON RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2019
-----------------------------------------------------
Last Update Date | 03/27/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2021 CUNNINGHAM DR
-----------------------------------------------------
City | HAMPTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23666-3375
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-243-2660
-----------------------------------------------------
Fax | 757-243-2757
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 510 WOODFIN RD
-----------------------------------------------------
City | NEWPORT NEWS
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23601-4451
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-263-9981
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WC0400X
-----------------------------------------------------
Taxonomy Name | Case Management Registered Nurse
-----------------------------------------------------
License Number | 0001131875
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------