Provider Demographics
NPI:1275339699
Name:DIXON, CECILIA (FNP-C)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:DIXON
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 DEER POND RD
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-0681
Mailing Address - Country:US
Mailing Address - Phone:936-635-3871
Mailing Address - Fax:
Practice Address - Street 1:180 MAGEE LN
Practice Address - Street 2:
Practice Address - City:GROVETON
Practice Address - State:TX
Practice Address - Zip Code:75845-4185
Practice Address - Country:US
Practice Address - Phone:936-642-0841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF01250464363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily