Provider Demographics
NPI:1902074289
Name:DIXON, SHARI LYNN (LMT)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:LYNN
Last Name:DIXON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 CENTER AVE.
Mailing Address - Street 2:
Mailing Address - City:CURTIS
Mailing Address - State:NE
Mailing Address - Zip Code:69025
Mailing Address - Country:US
Mailing Address - Phone:308-367-4220
Mailing Address - Fax:
Practice Address - Street 1:212 CENTER AVE.
Practice Address - Street 2:
Practice Address - City:CURTIS
Practice Address - State:NE
Practice Address - Zip Code:69025
Practice Address - Country:US
Practice Address - Phone:308-367-4220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1683225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist