Provider Demographics
NPI:1700648268
Name:NIXON, OYATA MARIE
Entity Type:Individual
Prefix:
First Name:OYATA
Middle Name:MARIE
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 1:3432 125TH DR NE UNIT B
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-6143
Mailing Address - Country:US
Mailing Address - Phone:161-281-7508
Mailing Address - Fax:
Practice Address - Street 1:3432 125TH DR NE UNIT B
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-6143
Practice Address - Country:US
Practice Address - Phone:161-281-7508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula