1336456680 NPI number — MRS. DIXIE DAWSON YOW MS, RD, LDN

Table of content: MRS. DIXIE DAWSON YOW MS, RD, LDN (NPI 1336456680)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336456680 NPI number — MRS. DIXIE DAWSON YOW MS, RD, LDN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAWSON YOW
Provider First Name:
DIXIE
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, RD, LDN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DAWSON
Provider Other First Name:
DIXIE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, RD, LDN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336456680
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3333 SILAS CREEK PKWY
Provider Second Line Business Mailing Address:
HEART & WELLNESS
Provider Business Mailing Address City Name:
WINSTON SALEM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27103-3013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-718-5941
Provider Business Mailing Address Fax Number:
336-277-0403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3333 SILAS CREEK PKWY
Provider Second Line Business Practice Location Address:
HEART & WELLNESS
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27103-3013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-718-5941
Provider Business Practice Location Address Fax Number:
336-277-0403
Provider Enumeration Date:
09/08/2010

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: 133V00000X , with the licence number:  L001506 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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