Individual
JAIMI DELANE DICKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LNV
Contact information
Practice address
2100 GARRISON DR, ROCKWALL, TX 75032-7283
(469) 237-1769
Mailing address
1965 SILVER HAWK DR, ST AUGUSTINE, FL 32092-4734
(469) 237-1769
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
205138
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104374100
—
FL
Enumeration date
01/02/2019
Last updated
03/02/2020
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