Lacey Beard Mixon, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-37700 Issued in AL

Practice address

1781 E Cottonwood Rd
Dothan, AL 36301-5309

Phone

(334) 678-5851

Fax

(334) 678-2803

NPI assigned

Sep 11, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536624000000",
    "number": "1295218774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MONROE ST STE 1600",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361043721",
            "telephone_number": "334-206-9344",
            "fax_number": "334-206-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 E COTTONWOOD RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363015309",
            "telephone_number": "334-678-5851",
            "fax_number": "334-678-2803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIXON",
        "first_name": "LACEY",
        "middle_name": "BEARD",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2018-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-37700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.