Individual
MARY DICKERSON
Active
Individual
MARY DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
L-10023320
DE
363LF0000X
Family Nurse Practitioner
Primary
AC003935
MD
Other
Enumeration date
12/09/2013
Last updated
11/08/2021
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