Provider Demographics
NPI:1053715573
Name:BIXLER, LINDA MICHELLE (FNP-C)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MICHELLE
Last Name:BIXLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MICHELLE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 DOCTORS DR STE 106
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31533-2202
Mailing Address - Country:US
Mailing Address - Phone:912-384-3338
Mailing Address - Fax:912-384-8214
Practice Address - Street 1:200 DOCTORS DR STE 106
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-2202
Practice Address - Country:US
Practice Address - Phone:912-384-3338
Practice Address - Fax:912-384-8214
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN191831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003153996AMedicaid
F1014375OtherCERTIFICATION
GARN191831OtherMEDICAL LICENSE
GARN191831OtherMEDICAL LICENSE
MT3472545OtherDEA