Provider Demographics
NPI:1588344279
Name:HIXON, ABBIE BROOKE (RNFA)
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:BROOKE
Last Name:HIXON
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:BROOKE
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5105 SE 60TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-1703
Mailing Address - Country:US
Mailing Address - Phone:580-232-0229
Mailing Address - Fax:
Practice Address - Street 1:3401 W GORE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6332
Practice Address - Country:US
Practice Address - Phone:580-250-5232
Practice Address - Fax:580-585-5478
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0133164163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant