Provider Demographics
NPI:1770269458
Name:DIXON, MADISON POPE (PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:MADISON
Middle Name:POPE
Last Name:DIXON
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:MADISON
Other - Middle Name:LOU
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4920 MARLIN CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6426
Mailing Address - Country:US
Mailing Address - Phone:910-305-0691
Mailing Address - Fax:
Practice Address - Street 1:2050 MERCANTILE DR
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-4053
Practice Address - Country:US
Practice Address - Phone:910-371-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5018330363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health