Provider Demographics
NPI:1821890823
Name:NIXON, DONNIE DANIEL III
Entity type:Individual
Prefix:
First Name:DONNIE
Middle Name:DANIEL
Last Name:NIXON
Suffix:III
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 91
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-0091
Mailing Address - Country:US
Mailing Address - Phone:336-865-4896
Mailing Address - Fax:
Practice Address - Street 1:1611 CASTLE HAYNE RD BLDG C
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-8859
Practice Address - Country:US
Practice Address - Phone:910-251-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
26619101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)