Provider Demographics
NPI:1811048978
Name:POE, DIXIE H (CRNP)
Entity type:Individual
Prefix:MRS
First Name:DIXIE
Middle Name:H
Last Name:POE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAYS RD
Mailing Address - Street 2:
Mailing Address - City:HARWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20776-9469
Mailing Address - Country:US
Mailing Address - Phone:301-261-9871
Mailing Address - Fax:
Practice Address - Street 1:100 GRAYS RD
Practice Address - Street 2:
Practice Address - City:HARWOOD
Practice Address - State:MD
Practice Address - Zip Code:20776-9469
Practice Address - Country:US
Practice Address - Phone:301-261-9871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR091453363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily