Individual
MARY W. DICKERSON
Active
Individual
MARY W. DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Taxonomy
Speciality
Code
Description
License number
State
163WW0101X
Ambulatory Women's Health Care Registered Nurse
31542
NE
176B00000X
Midwife
Primary
120051
NE
Other
Enumeration date
08/12/2011
Last updated
02/06/2013
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