Provider Demographics
NPI:1467087015
Name:DIX, CAPRI KAYE (FNP)
Entity Type:Individual
Prefix:
First Name:CAPRI
Middle Name:KAYE
Last Name:DIX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5686 GRISWOLD RD
Mailing Address - Street 2:
Mailing Address - City:BYRON
Mailing Address - State:NY
Mailing Address - Zip Code:14422-9605
Mailing Address - Country:US
Mailing Address - Phone:585-993-0654
Mailing Address - Fax:
Practice Address - Street 1:3670 S BENZING RD STE A
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1741
Practice Address - Country:US
Practice Address - Phone:716-662-5357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily