MEDICARE: PATRICIA DIX ANP

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	363LA2200X	Adult Health Nurse Practitioner	900409	NC

General Provider Information

NPI Number	:	1629036397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA DIX ANP

Provider Business Mailing Address
First Line	:	1850 W ARLINGTON BLVD
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-5704
Country	:	US
Telephone Number	:	252-752-6101
Fax Number	:	252-752-6600

Provider Business Practice Location Address
First Line	:	PHYSICIANS EAST UGENT CARE
Second Line	:	1913 EAST FIRETOWER ROAD
City	:	GREENVILLE
State	:	NC
Zip	:	27858-8545
Country	:	US
Telephone Number	:	252-355-4357
Fax Number	:	252-355-4187

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	07/08/2007

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