Individual
MISS COREY MITCHELL DICKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5900 GARNERS FERRY RD, COLUMBIA, SC 29209-1301
(803) 695-5450
(803) 695-5469
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 434-1488
(803) 434-1537
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23062
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6147
—
SC
Enumeration date
07/07/2019
Last updated
10/01/2019
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