Individual
MRS. KIMBERLY WHALEN DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
205 SE WILSON AVE STE 1, BEND, OR 97702-1799
(541) 312-5849
Mailing address
3570 BLACK OAK RD, EUGENE, OR 97405-4416
(843) 575-4355
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201042132RN
OR
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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