Provider Demographics
NPI:1760707251
Name:DIXON, NAOMI DIAN (APRN)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:DIAN
Last Name:DIXON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 AIRPORT RD
Mailing Address - Street 2:STE D
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-8184
Mailing Address - Country:US
Mailing Address - Phone:501-625-7500
Mailing Address - Fax:501-625-7777
Practice Address - Street 1:1661 AIRPORT RD STE F
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-8184
Practice Address - Country:US
Practice Address - Phone:501-651-4300
Practice Address - Fax:501-651-4318
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003364363LF0000X
ARA03364 ANP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR183670758Medicaid