Provider Demographics
NPI:1194448886
Name:DIXON, GEORGIA SHARON
Entity type:Individual
Prefix:
First Name:GEORGIA
Middle Name:SHARON
Last Name:DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GEORGIA
Other - Middle Name:SHARON
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:391 LAS PALMAS ST
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1027
Mailing Address - Country:US
Mailing Address - Phone:561-452-7735
Mailing Address - Fax:
Practice Address - Street 1:391 LAS PALMAS ST
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1027
Practice Address - Country:US
Practice Address - Phone:561-452-7735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11022013363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health