Individual
JOAN LORRAINE DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
76 CARDINAL RIDGE RD, CHAPEL HILL, NC 27516-9834
(773) 425-5054
Mailing address
76 CARDINAL RIDGE RD, CHAPEL HILL, NC 27516-9834
(773) 425-5054
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001010965
NC
363A00000X
Physician Assistant
085.004604
IL
Other
Enumeration date
02/26/2013
Last updated
12/08/2021
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