Individual
JACQUALINE DRAKE DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP - C
Contact information
Practice address
526 HALLE PARK DR, COLLIERVILLE, TN 38017-7085
(901) 910-3246
Mailing address
8418 REGAL BEND DR, OLIVE BRANCH, MS 38654-4415
(662) 512-2237
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
902387
MS
363LF0000X
Family Nurse Practitioner
Primary
APN0000024154
TN
Other
Enumeration date
03/11/2019
Last updated
02/19/2021
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