Individual
MS. LAVERNE LYDIA DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1575 BLUE HILL AVE, MATTAPAN, MA 02126-2122
(617) 296-0061
Mailing address
9 WALTON ST, DORCHESTER, MA 02124-3614
(857) 205-2179
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN253735
MA
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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