Provider Demographics
NPI:1992444046
Name:HIXSON, MEGAN L (DPT)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:L
Last Name:HIXSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 W INTERSTATE AVE BLDG 3
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0955
Mailing Address - Country:US
Mailing Address - Phone:701-223-8717
Mailing Address - Fax:701-255-3957
Practice Address - Street 1:18881 W DODGE RD STE 300W
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:NE
Practice Address - Zip Code:68022-4648
Practice Address - Country:US
Practice Address - Phone:877-230-3885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTP-PT-LIC-24338225100000X
ND2623225100000X
AZCP038614T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist