Provider Demographics
NPI:1962294538
Name:DIXON, SARA BETH (RN BSN)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:BETH
Last Name:DIXON
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:BETH
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN BSN
Mailing Address - Street 1:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657
Mailing Address - Country:US
Mailing Address - Phone:570-836-3131
Mailing Address - Fax:570-836-1639
Practice Address - Street 1:1 COURTHOUSE SQUARE
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657
Practice Address - Country:US
Practice Address - Phone:570-614-4308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN650198163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse