Mixon, Gina H
Mixon, Gina H is an individual health care provider with primary practice located at 1220 Jefferson St , Laurel MS 39440-4355. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Mixon, Gina H can be contacted via phone (601) 426-4086.Contact Information
Primary practice address
1220 Jefferson St
Laurel MS 39440-4355
Phone: (601) 426-4086
Fax: (601) 426-4417
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X | D0722 | Mississippi |
Profile Details
| NPI number | 1902807720 |
|---|---|
| LBN Legal business name | Mixon, Gina H |
| Credentials | Registered Dietitian (RD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2005 |
| Last updated | Nov 3rd, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902807720 | NPPES |
| Mississippi | MEDICAID | 06023396 |
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