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Individual
TRACY LYNN DICKISON
Active
Individual
TRACY LYNN DICKISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Taxonomy
Speciality
Code
Description
License number
State
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
CNS0448
MN
364SG0600X
Gerontology Clinical Nurse Specialist
R161111-3
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225376338
—
MN
05
—
1225376338
—
WI
Enumeration date
01/24/2013
Last updated
06/14/2018
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