Provider Demographics
NPI:1437757432
Name:DIXON, KATIE JO (FNP-C)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:JO
Last Name:DIXON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:JO
Other - Last Name:DIXON-BLABOE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5310 JOE SAYERS AVE
Mailing Address - Street 2:APARTMENT 205
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756
Mailing Address - Country:US
Mailing Address - Phone:512-790-4376
Mailing Address - Fax:
Practice Address - Street 1:195 S HASLER BLVD
Practice Address - Street 2:B-1
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602
Practice Address - Country:US
Practice Address - Phone:512-308-1555
Practice Address - Fax:512-308-1565
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1015498363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care