Individual
MRS. HEATHER NICOLE DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
8211 W STATE ROUTE 66 STE A, NEWBURGH, IN 47630-2534
(812) 490-0463
(877) 513-8132
Mailing address
8112 OBRIAN BLVD, NEWBURGH, IN 47630-8939
(618) 553-2718
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71010398A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71010398A
IN STATE LICENSE
IN
Enumeration date
08/28/2020
Last updated
09/22/2020
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