1396734232 NPI number — MRS. DAWN MCILVRIED NIXON MS, CGC, LGC

Table of content: MRS. DAWN MCILVRIED NIXON MS, CGC, LGC (NPI 1396734232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396734232 NPI number — MRS. DAWN MCILVRIED NIXON MS, CGC, LGC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NIXON
Provider First Name:
DAWN
Provider Middle Name:
MCILVRIED
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, CGC, LGC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCILVRIED
Provider Other First Name:
DAWN
Provider Other Middle Name:
ELLEN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, CGC, LGC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396734232
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/12/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8301 HARCOURT ROAD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
INDIANAOPLIS
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46260
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-415-6689
Provider Business Mailing Address Fax Number:
317-583-2436

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8301 HARCOURT ROAD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
INDIANAOPLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46260
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-415-6689
Provider Business Practice Location Address Fax Number:
317-583-2436
Provider Enumeration Date:
10/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 170300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com