Provider Demographics
NPI:1659056489
Name:DIXON, KAYCI LANAE (CRNP)
Entity Type:Individual
Prefix:
First Name:KAYCI
Middle Name:LANAE
Last Name:DIXON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 W LAGOON AVE
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-6124
Mailing Address - Country:US
Mailing Address - Phone:601-508-9824
Mailing Address - Fax:
Practice Address - Street 1:1328 W LAGOON AVE
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-6124
Practice Address - Country:US
Practice Address - Phone:601-508-9824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-166062363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics