Provider Demographics
NPI:1104204007
Name:NIXON, DELINA FAY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DELINA
Middle Name:FAY
Last Name:NIXON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5074 SUMTER AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-3825
Mailing Address - Country:US
Mailing Address - Phone:513-348-4113
Mailing Address - Fax:
Practice Address - Street 1:5074 SUMTER AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3825
Practice Address - Country:US
Practice Address - Phone:513-348-4113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.151123-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse