MEDICARE: NATALIE NIXSON

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	106H00000X	Marriage & Family Therapist		PA

General Provider Information

NPI Number	:	1942036868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE NIXSON

Provider Business Mailing Address
First Line	:	5102 ROCHELLE AVE UNIT 6
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-3818
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7901 BUSTLETON AVE STE 300
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-3330
Country	:	US
Telephone Number	:	215-537-5367
Fax Number	:

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

Provider Enumeration Date	:	09/09/2024
Last Update Date	:	09/05/2025

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Directions to “ NATALIE NIXSON ” Practice Location

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