Individual
SANDRA DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
130 HWY 252, COLUMBIA, SC 29261
(803) 231-2600
Mailing address
PO BOX 485, COLUMBIA, SC 29202-0485
(803) 898-8405
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19618
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0669
—
SC
Enumeration date
07/09/2006
Last updated
02/27/2009
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