Provider Demographics
NPI:1386008902
Name:NIXON, MORGAN CHRISTEN
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:CHRISTEN
Last Name:NIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 CITY AVE APT 177
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-3864
Mailing Address - Country:US
Mailing Address - Phone:405-388-5217
Mailing Address - Fax:
Practice Address - Street 1:913 CITY AVE APT 177
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-3864
Practice Address - Country:US
Practice Address - Phone:405-388-5217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-09
Last Update Date:2016-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKT083730371390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program