Provider Demographics
NPI:1578394367
Name:NCHE, NIXON FRU
Entity type:Individual
Prefix:
First Name:NIXON
Middle Name:FRU
Last Name:NCHE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NIXON
Other - Middle Name:FRU
Other - Last Name:NCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14019 CASTLE BLVD APT 303
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4716
Mailing Address - Country:US
Mailing Address - Phone:301-232-4760
Mailing Address - Fax:
Practice Address - Street 1:4645 NANNIE HELEN BURROUGHS AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3622
Practice Address - Country:US
Practice Address - Phone:651-210-8051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator