Provider Demographics
NPI:1821740689
Name:NIXON, JANUARY
Entity Type:Individual
Prefix:
First Name:JANUARY
Middle Name:
Last Name:NIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 BALLYCLARE TER
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-4002
Mailing Address - Country:US
Mailing Address - Phone:678-732-6615
Mailing Address - Fax:
Practice Address - Street 1:460 BALLYCLARE TER
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-4002
Practice Address - Country:US
Practice Address - Phone:678-732-6615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN427280163WN1003X, 163WC0400X, 163WC1500X, 163WC1600X, 163WG0600X, 163WD0400X, 171M00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No171M00000XOther Service ProvidersCase Manager/Care Coordinator