Individual
CARLY DAWN DICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3651 COLLEGE BLVD STE 100B, LEAWOOD, KS 66211-1910
(913) 362-0031
(913) 319-7662
Mailing address
3651 COLLEGE BLVD STE 100B, LEAWOOD, KS 66211-1910
(913) 362-0031
(913) 319-7662
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01862
KS
Other
Enumeration date
05/07/2015
Last updated
07/21/2022
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