Provider Demographics
NPI:1710738489
Name:NIXON, AUBREY A (LMT)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:A
Last Name:NIXON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MONETT
Mailing Address - State:MO
Mailing Address - Zip Code:65708-2330
Mailing Address - Country:US
Mailing Address - Phone:417-988-6406
Mailing Address - Fax:
Practice Address - Street 1:308 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708-2330
Practice Address - Country:US
Practice Address - Phone:417-988-6406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist