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NPI Code Detail

MEDICARE: JAIME L DIXON FNP-BC

MEDICARE: JAIME L DIXON FNP-BC
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
1363LF0000XFamily Nurse Practitioner65921WV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00986496OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790068534
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAIME L DIXON FNP-BC
Provider Business Mailing Address
First Line : 3075 US ROUTE 60
Second Line :
City : HUNTINGTON
State : WV
Zip : 25705-8859
Country : US
Telephone Number : 304-528-4600
Fax Number :
Provider Business Practice Location Address
First Line : 3075 US ROUTE 60 STE D265
Second Line :
City : HUNTINGTON
State : WV
Zip : 25705-8859
Country : US
Telephone Number : 304-528-4600
Fax Number : 304-399-2280
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2011
Last Update Date : 06/01/2026

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Directions to “ JAIME L DIXON FNP-BC” Practice Location

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