Provider Demographics
NPI:1417786443
Name:DIXON, NATALIE R
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:R
Last Name:DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14575 W MOUNTAIN VIEW BLVD UNIT 12206
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-8679
Mailing Address - Country:US
Mailing Address - Phone:510-224-7483
Mailing Address - Fax:
Practice Address - Street 1:10451 W PALMERAS DR UNIT 203E
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85373-2011
Practice Address - Country:US
Practice Address - Phone:510-224-7483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-15133225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist