Provider Demographics
NPI:1386182269
Name:HIXON, LAURA ANN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ANN
Last Name:HIXON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:ANN
Other - Last Name:TANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 RIVERFRONT PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-2198
Mailing Address - Country:US
Mailing Address - Phone:423-698-8981
Mailing Address - Fax:423-697-7109
Practice Address - Street 1:901 RIVERFRONT PKWY STE 300
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-2198
Practice Address - Country:US
Practice Address - Phone:423-698-8981
Practice Address - Fax:423-697-7109
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8258363A00000X
TNPA0000003184363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant