Provider Demographics
NPI:1144083320
Name:NIXON, JOELLE VICTORIA DOCTOR
Entity type:Individual
Prefix:MRS
First Name:JOELLE
Middle Name:VICTORIA DOCTOR
Last Name:NIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8327 SILKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-1894
Mailing Address - Country:US
Mailing Address - Phone:804-514-2944
Mailing Address - Fax:
Practice Address - Street 1:7229 FOREST AVE STE 100
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3765
Practice Address - Country:US
Practice Address - Phone:804-673-1119
Practice Address - Fax:804-673-1377
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001280631163W00000X
VA24192060363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse