Provider Demographics
NPI:1841901659
Name:DIXON, MARIA ISABELLE DE LEON (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ISABELLE DE LEON
Last Name:DIXON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:ISABLELLE ROLDAN
Other - Last Name:DE LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:719 GREEN VALLEY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7022
Mailing Address - Country:US
Mailing Address - Phone:336-832-3600
Mailing Address - Fax:
Practice Address - Street 1:719 GREEN VALLEY RD STE 101
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7022
Practice Address - Country:US
Practice Address - Phone:336-832-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF11220018363LF0000X, 363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily