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Individual

MS. LORI BIZZELL DICKENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(919) 599-2473
Mailing address
1506 RUMSTONE LN, CHARLOTTE, NC 28262-4218
(919) 599-2473

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
237390
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
090164
NC

Other

Enumeration date
06/08/2012
Last updated
10/28/2020
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