Individual
MONIQUE DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
505 S PLUMMER AVE, CHANUTE, KS 66720-1950
(620) 431-2500
(620) 431-4418
Mailing address
PO BOX 946, CHANUTE, KS 66720-0946
(620) 431-2500
(620) 431-4418
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
77451
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201145440A
—
KS
Enumeration date
11/08/2016
Last updated
01/06/2017
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