MEDICARE: SIERRA 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
1	171M00000X	Case Manager/Care Coordinator		LA

General Provider Information

NPI Number	:	1437013604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA DIXON

Provider Business Mailing Address
First Line	:	230 VETERANS BLVD STE A
Second Line	:
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-4725
Country	:	US
Telephone Number	:	225-612-8656
Fax Number	:

Provider Business Practice Location Address
First Line	:	11861 COURSEY BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-4404
Country	:	US
Telephone Number	:	225-612-8656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “ SIERRA DIXON ” Practice Location

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