Provider Demographics
NPI:1861277956
Name:DIXON, CHASITY (NRP)
Entity type:Individual
Prefix:
First Name:CHASITY
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:NRP
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 163
Mailing Address - Street 2:
Mailing Address - City:CANDO
Mailing Address - State:ND
Mailing Address - Zip Code:58324-0163
Mailing Address - Country:US
Mailing Address - Phone:770-324-5911
Mailing Address - Fax:
Practice Address - Street 1:808 6TH ST
Practice Address - Street 2:
Practice Address - City:CANDO
Practice Address - State:ND
Practice Address - Zip Code:58324-6426
Practice Address - Country:US
Practice Address - Phone:770-324-5911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant