Provider Demographics
NPI:1528309622
Name:DIXON, TERESA (RN, TTS)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:RN, TTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 242
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-0242
Mailing Address - Country:US
Mailing Address - Phone:740-582-2684
Mailing Address - Fax:
Practice Address - Street 1:100 W MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1275
Practice Address - Country:US
Practice Address - Phone:740-296-5029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN309403163W00000X, 163WA0400X, 163WC0400X, 163WC1500X, 163WC1600X, 163WD0400X, 163WG0000X, 163WM1400X, 163WN1003X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health