Individual
JENNIFER LEIGH DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
115 K D REVELL RD, WAUCHULA, FL 33873-2051
(863) 773-4161
Mailing address
4924 WILLIAMSTOWN BLVD, LAKELAND, FL 33810-3705
(863) 430-2431
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11017698
FL
Other
Enumeration date
04/14/2022
Last updated
04/14/2022
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