Provider Demographics
NPI:1700261914
Name:NIXON, BREANNE SKY (BS-PSYCHOLOGY)
Entity Type:Individual
Prefix:
First Name:BREANNE
Middle Name:SKY
Last Name:NIXON
Suffix:
Gender:F
Credentials:BS-PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 IVY BEND CIR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6858
Mailing Address - Country:US
Mailing Address - Phone:304-904-1327
Mailing Address - Fax:
Practice Address - Street 1:611 8TH ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-3084
Practice Address - Country:US
Practice Address - Phone:931-920-7289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator