Provider Demographics
NPI:1669760054
Name:NIXON, KERRI A (NP)
Entity type:Individual
Prefix:MS
First Name:KERRI
Middle Name:A
Last Name:NIXON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 E ROBINSON RD STE 205
Mailing Address - Street 2:
Mailing Address - City:WEST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2044
Mailing Address - Country:US
Mailing Address - Phone:716-691-3400
Mailing Address - Fax:
Practice Address - Street 1:3950 E ROBINSON RD STE 205
Practice Address - Street 2:
Practice Address - City:WEST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2044
Practice Address - Country:US
Practice Address - Phone:716-691-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF382224-1363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics