Basic Information
| Provider Information | |||||||||
| NPI: | 1134287477 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PIXLEY-DAWSON | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | JOANNE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PA -C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PIXLEY | ||||||||
| OtherFirstName: | JENNIFER | ||||||||
| OtherMiddleName: | JOANNE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PA-C | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1260 INNOVATION PKWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | GREENWOOD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461433602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178845200 | ||||||||
| FaxNumber: | 3178845360 | ||||||||
| Practice Location | |||||||||
| Address1: | 1260 INNOVATION PKWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | GREENWOOD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461433602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178845200 | ||||||||
| FaxNumber: | 3178845360 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2006 | ||||||||
| LastUpdateDate: | 05/29/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 10001121A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.