Provider Demographics
NPI:1487118972
Name:HIXSON, LEAH JOY (RD)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:JOY
Last Name:HIXSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2549
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80201-0001
Mailing Address - Country:US
Mailing Address - Phone:720-900-1697
Mailing Address - Fax:
Practice Address - Street 1:1315 E 37TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3303
Practice Address - Country:US
Practice Address - Phone:937-212-1166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered