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NPI Code Detail

MEDICARE: MS. TANENA L. DIXON

MEDICARE: MS. TANENA L. DIXON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171W00000XContractorPT2464DC

General Provider Information

NPI Number : 1346492782
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TANENA L. DIXON
Provider Business Mailing Address
First Line : 2111 BRANCH AVE SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20020-3337
Country : US
Telephone Number : 202-276-6063
Fax Number :
Provider Business Practice Location Address
First Line : 2111 BRANCH AVE SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20020-3337
Country : US
Telephone Number : 202-276-6063
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2008
Last Update Date : 10/16/2008

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Directions to “ MS. TANENA L. DIXON ” Practice Location

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