Individual
ELIZABETH SUZAN DYKEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
8021 WATSON RD, WEBSTER GROVES, MO 63119-5304
(866) 389-2727
Mailing address
33 E AIRLINE DR, EAST ALTON, IL 62024-1703
(314) 374-9965
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2023001205
MO
363LF0000X
Family Nurse Practitioner
Primary
209026921
IL
Other
Enumeration date
01/30/2023
Last updated
04/09/2024
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