Individual
MRS. TINA MARIE DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
1200 DRIVING PARK AVE, NEWARK, NY 14513-1090
(315) 359-2847
(315) 359-2806
Mailing address
NEWARK WAYNE COMMUNITY HOSPITAL 111 DRIVING PARK AVE, BOX 111, EMERGENCY DEPARTMENT, NEWARK, NY 14513
(315) 359-2847
(315) 359-2806
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F308478-1
NY
Other
Enumeration date
05/24/2018
Last updated
09/15/2022
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