Provider Demographics
NPI:1619014388
Name:NIXON, BRIGITTE KATE (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIGITTE
Middle Name:KATE
Last Name:NIXON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1348 NE CUSHING DR
Mailing Address - Street 2:STE. 200
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3876
Mailing Address - Country:US
Mailing Address - Phone:541-382-7696
Mailing Address - Fax:541-389-5723
Practice Address - Street 1:1348 NE CUSHING DR
Practice Address - Street 2:STE. 200
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-3876
Practice Address - Country:US
Practice Address - Phone:541-382-7696
Practice Address - Fax:541-389-5723
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD25725207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR269827Medicaid
ORR133304Medicare PIN
ORI46085Medicare UPIN