Provider Demographics
NPI:1114944667
Name:DIXON-VICTOR, LINDA A (MSN, FNP-BC, BSN, RN)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:DIXON-VICTOR
Suffix:
Gender:F
Credentials:MSN, FNP-BC, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BLDG 36000, DARNALL LOOP
Mailing Address - Street 2:
Mailing Address - City:FORT CAVAZOS
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:254-553-0671
Mailing Address - Fax:254-288-8712
Practice Address - Street 1:BLDG. 36000, DARNALL LOOP
Practice Address - Street 2:
Practice Address - City:FORT CAVAZOS
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-553-0671
Practice Address - Fax:254-288-8712
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129722363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE020224D18Medicare PIN
Q76077Medicare UPIN