Individual provider · Type 1 NPI
Deitra T. Mixer
Specialist · Cane Ridge, TN
NPI number
1053635755
Active
Practice location
8221 Lenox Creekside Dr Unit 7
Cane Ridge, TN 37013-4657
Mailing address
8221 Lenox Creekside Dr, Unit 7
Cane Ridge, TN 37013-4656
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | None listed |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
About NPI 1053635755
Deitra T. Mixer's National Provider Identifier is 1053635755, issued on Mar 24, 2010. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Cane Ridge, TN. The record was last updated on Mar 24, 2010.