Individual
MRS. JAMIE POLING DICKERHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6322 FAYETTEVILLE RD, RAEFORD, NC 28376-7979
(910) 878-6700
(910) 878-6705
Mailing address
6322 FAYETTEVILLE RD, RAEFORD, NC 28376-7979
(910) 878-6700
(910) 878-6705
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
148570
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7000634
—
NC
01
—
P00887113
RAILROAD MEDICARE
NC
Enumeration date
10/23/2009
Last updated
09/06/2023
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