Provider Demographics
NPI:1760888655
Name:DIXON, LOIS M (AGNP)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:M
Last Name:DIXON
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:M
Other - Last Name:REGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HYGEIA DRIVE
Mailing Address - Street 2:SUITE 2300
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2049
Mailing Address - Country:US
Mailing Address - Phone:610-268-3631
Mailing Address - Fax:302-733-1968
Practice Address - Street 1:3710 KENNETT PIKE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:DE
Practice Address - Zip Code:19807-2157
Practice Address - Country:US
Practice Address - Phone:302-623-6300
Practice Address - Fax:302-623-6306
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELP-000123363LA2200X, 363LG0600X
DELP-0000123363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology