Provider Demographics
NPI:1033227103
Name:NIXON, JOHN P (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:P
Last Name:NIXON
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 EDMONTON RD
Mailing Address - Street 2:
Mailing Address - City:TOMPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42167-9402
Mailing Address - Country:US
Mailing Address - Phone:270-487-6155
Mailing Address - Fax:
Practice Address - Street 1:1513 EDMONTON RD
Practice Address - Street 2:
Practice Address - City:TOMPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42167-9402
Practice Address - Country:US
Practice Address - Phone:270-487-6155
Practice Address - Fax:270-487-6157
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist