Individual
MS. KAITLYN DICKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1250 N VANTAGE POINT DR, CRYSTAL RIVER, FL 34429-5736
(352) 795-0644
Mailing address
1250 N VANTAGE POINT DR, CRYSTAL RIVER, FL 34429-5736
(352) 795-0644
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
ND7665
FL
363AM0700X
Medical Physician Assistant
Primary
9112407
FL
Other
Enumeration date
01/21/2016
Last updated
03/05/2020
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