Individual
JACOB EDWARD DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNAP
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3100
Mailing address
21781 E 785 RD, WELLING, OK 74471-2035
(918) 457-6922
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
208980
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2022
Last updated
07/10/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us