Individual
MICHELE DICKENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1869 HICKORY RD, KIMBALL, MI 48074-2623
(810) 841-0693
Mailing address
1869 HICKORY RD, KIMBALL, MI 48074-2623
(810) 841-0693
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703113527
MI
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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