Provider Demographics
NPI:1891409306
Name:DILLON, ALEXIS NICHOLS (BSN, RN)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:NICHOLS
Last Name:DILLON
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6409 ROCKREST CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-6500
Mailing Address - Country:US
Mailing Address - Phone:919-830-2550
Mailing Address - Fax:
Practice Address - Street 1:6409 ROCKREST CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6500
Practice Address - Country:US
Practice Address - Phone:919-830-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC307034163WG0000X
NC5021171363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice