Provider Demographics
NPI:1598267718
Name:NIXON, BETTY ANNE (RN)
Entity Type:Individual
Prefix:
First Name:BETTY ANNE
Middle Name:
Last Name:NIXON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-1909
Mailing Address - Country:US
Mailing Address - Phone:609-216-4040
Mailing Address - Fax:
Practice Address - Street 1:650 RANCOCAS RD
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-5613
Practice Address - Country:US
Practice Address - Phone:609-518-2243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-03
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO10632000163WP0808X
NJ26NJ00810500363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ00810500OtherADVANCED PRACTICE NURSE