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1376101196
DETRA K DIXON
MACON, GA
NPI
1376101196
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA RN213793)
Enumeration Date
2019-06-05
Last Update Date
2022-06-29
Business Address
DETRA K DIXON FNP
227 AMALIE DR
MACON, GA 31220-2667
Phone number: 478-731-9521
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Mailing Address
DETRA K DIXON FNP
227 AMALIE DR
MACON, GA 31220-2667
Phone number: 478-731-9521
Copy
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