Basic Information
| Provider Information | |||||||||
| NPI: | 1659028470 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIX | ||||||||
| FirstName: | BRANDY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NURSE PRACTITIONER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1348 5TH ST | ||||||||
| Address2: | |||||||||
| City: | SEWARD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 159543103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143414788 | ||||||||
| FaxNumber: | 8144466446 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 E MURPHY AVE | ||||||||
| Address2: | |||||||||
| City: | CONNELLSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154252724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7246281500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2022 | ||||||||
| LastUpdateDate: | 08/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | SP025398 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.