Provider Demographics
NPI:1477872570
Name:DIXON, CARYN CHRISTINE
Entity Type:Individual
Prefix:
First Name:CARYN
Middle Name:CHRISTINE
Last Name:DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:CHRISTINE
Other - Last Name:BALLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1272 GARRISON DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2598
Mailing Address - Country:US
Mailing Address - Phone:615-867-8060
Mailing Address - Fax:615-893-2590
Practice Address - Street 1:1272 GARRISON DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2598
Practice Address - Country:US
Practice Address - Phone:615-867-8060
Practice Address - Fax:615-893-2590
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000014911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1523543Medicaid
TN1523543Medicaid