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Individual

TRACY LYNN DICKISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNS

Contact information

Practice address
400 E 3RD ST, ESSENTIA HEALTH DULUTH CLINIC, DULUTH, MN 55805
(218) 786-8364
Mailing address
400 E 3RD ST, ESSENTIA HEALTH DULUTH CLINIC, DULUTH, MN 55805-1951
(218) 786-8364

Taxonomy

Speciality
Code
Description
License number
State
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
CNS0448
MN
364SG0600X
Gerontology Clinical Nurse Specialist
R161111-3
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1225376338
MN
05
1225376338
WI
Enumeration date
01/24/2013
Last updated
06/14/2018
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