Individual
DR. SHANTELISE MONIQUE DICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, CPNP-PC
Contact information
Practice address
300 HOWELL ST, THOMASTON, GA 30286-5402
(706) 975-8662
Mailing address
300 HOWELL ST, THOMASTON, GA 30286-5402
(706) 975-8662
(706) 646-5069
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN199300
GA
Other
Enumeration date
05/06/2019
Last updated
05/06/2019
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