Provider Demographics
NPI:1609547736
Name:DIXON, MOLLY CATHRYN (PNP)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:CATHRYN
Last Name:DIXON
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10116 N MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64157-7926
Mailing Address - Country:US
Mailing Address - Phone:816-590-7244
Mailing Address - Fax:
Practice Address - Street 1:9151 NE 81ST TER STE 240
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-1307
Practice Address - Country:US
Practice Address - Phone:816-207-0070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021008712363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics