Provider Demographics
NPI:1043069404
Name:NIXON, VALERI ANDREA
Entity type:Individual
Prefix:
First Name:VALERI
Middle Name:ANDREA
Last Name:NIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VALERI
Other - Middle Name:ANDREA
Other - Last Name:GONZALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16058 S 88TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-3259
Mailing Address - Country:US
Mailing Address - Phone:918-894-3863
Mailing Address - Fax:
Practice Address - Street 1:16058 S 88TH EAST AVE
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-3259
Practice Address - Country:US
Practice Address - Phone:918-894-3863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator