1457996639 NPI number — JULIANNA WHITFILL NIXON PA-C

Table of content: JULIANNA WHITFILL NIXON PA-C (NPI 1457996639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457996639 NPI number — JULIANNA WHITFILL NIXON PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NIXON
Provider First Name:
JULIANNA
Provider Middle Name:
WHITFILL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHITFILL
Provider Other First Name:
JULIANNA
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457996639
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/26/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4196 HIGHWAY 62 412 STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARDY
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72542-8002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 W MORTON ST STE AM
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND CITY
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47660-7697
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-922-2099
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/12/2019

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: 363A00000X , with the licence number:  10004204A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363A00000X , with the licence number: TC892 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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