Individual
MARIANNE TISON DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
7985 S MACKINAW TRL, CADILLAC, MI 49601-8111
(231) 876-6100
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
06634
OH
367A00000X
Advanced Practice Midwife
Primary
4704129416
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2286413
—
OH
05
—
4934721
—
MI
Enumeration date
06/27/2005
Last updated
11/23/2020
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