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NPI Code Detail

MEDICARE: BETHANY A DIXON RN

MEDICARE: BETHANY A DIXON RN
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
1163WP2201XAmbulatory Care Registered NurseR31061ND

General Provider Information

NPI Number : 1376366575
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETHANY A DIXON RN
Provider Business Mailing Address
First Line : 2101 ELM ST N
Second Line :
City : FARGO
State : ND
Zip : 58102-2417
Country : US
Telephone Number : 701-239-3700
Fax Number :
Provider Business Practice Location Address
First Line : 2101 ELM ST N
Second Line :
City : FARGO
State : ND
Zip : 58102-2417
Country : US
Telephone Number : 701-239-3700
Fax Number : 701-239-3777
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2024
Last Update Date : 04/09/2026

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