Individual
MR. KEVIN DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
200 E CHESTNUT ST, LOUISVILLE, KY 40202-1800
(502) 636-7111
Mailing address
3112 TIMBERLAKE CT, JEFFERSONVILLE, IN 47130-7629
(812) 989-9650
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3013376
KY
Other
Enumeration date
06/03/2019
Last updated
06/06/2019
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