Individual
TIFFANY RHETT DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3210 N BLUE STAR DR, FAYETTEVILLE, AR 72703-3678
(479) 283-2871
Mailing address
PO BOX 8162, FAYETTEVILLE, AR 72703-0003
(479) 283-2871
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R078489
AR
163WE0003X
Emergency Registered Nurse
R078489
AR
163WN0800X
Neuroscience Registered Nurse
R078489
AR
363LF0000X
Family Nurse Practitioner
Primary
230351
AR
Other
Enumeration date
01/18/2025
Last updated
10/02/2025
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