Provider Demographics
NPI:1063648434
Name:ANDELMAN, DIXIE MARIE BENNETT (FNP)
Entity Type:Individual
Prefix:DR
First Name:DIXIE
Middle Name:MARIE BENNETT
Last Name:ANDELMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DIXIE
Other - Middle Name:MARIE
Other - Last Name:LEDGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 61160
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-1160
Mailing Address - Country:US
Mailing Address - Phone:361-884-2904
Mailing Address - Fax:361-857-0572
Practice Address - Street 1:14254 SPID DR STE 207
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418
Practice Address - Country:US
Practice Address - Phone:361-589-4068
Practice Address - Fax:361-589-4079
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX684604363L00000X, 363LF0000X
TXAP117983363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner