Provider Demographics
NPI:1417444860
Name:NIXON, CIARA (LPN)
Entity Type:Individual
Prefix:
First Name:CIARA
Middle Name:
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 1:330 STUDENT HEALTH CTR
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:16802-2129
Mailing Address - Country:US
Mailing Address - Phone:814-865-6556
Mailing Address - Fax:814-865-6982
Practice Address - Street 1:330 STUDENT HEALTH CTR
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802-2129
Practice Address - Country:US
Practice Address - Phone:814-865-6556
Practice Address - Fax:814-865-6982
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN296721164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse