MEDICARE: MS. KERRI A. NIXON N.P.

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	363LP0200X	Pediatric Nurse Practitioner	F382224-1	NY

General Provider Information

NPI Number	:	1669760054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KERRI A. NIXON N.P.

Provider Business Mailing Address
First Line	:	3950 E ROBINSON RD STE 205
Second Line	:
City	:	WEST AMHERST
State	:	NY
Zip	:	14228-2044
Country	:	US
Telephone Number	:	716-691-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	3950 E ROBINSON RD STE 205
Second Line	:
City	:	WEST AMHERST
State	:	NY
Zip	:	14228-2044
Country	:	US
Telephone Number	:	716-691-3400
Fax Number	:

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

Provider Enumeration Date	:	07/19/2011
Last Update Date	:	01/25/2012

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