Provider Demographics
NPI:1003292889
Name:DIXON, ANDREA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-1489
Mailing Address - Country:US
Mailing Address - Phone:320-656-8888
Mailing Address - Fax:320-203-7785
Practice Address - Street 1:707 1ST AVE N
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-1489
Practice Address - Country:US
Practice Address - Phone:320-656-8888
Practice Address - Fax:320-203-7785
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist