Provider Demographics
NPI:1043264435
Name:NIXON, CATHLEEN J (FNP)
Entity Type:Individual
Prefix:
First Name:CATHLEEN
Middle Name:J
Last Name:NIXON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-8983
Mailing Address - Country:US
Mailing Address - Phone:864-227-5020
Mailing Address - Fax:
Practice Address - Street 1:102 ROCKCREEK BLVD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-8915
Practice Address - Country:US
Practice Address - Phone:864-227-5020
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCB0829OtherMEDCOST
SCNP0218Medicaid
SCB0829OtherMEDCOST