Provider Demographics
NPI:1245218387
Name:DIXON, KELLY HERGER (WHNP)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:HERGER
Last Name:DIXON
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4460 ALDERNY CIR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-9276
Mailing Address - Country:US
Mailing Address - Phone:336-681-6516
Mailing Address - Fax:
Practice Address - Street 1:371 NC HIGHWAY 65 STE 204
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-8881
Practice Address - Country:US
Practice Address - Phone:336-342-8140
Practice Address - Fax:336-342-8356
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0050-00471363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health