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Individual

PEARL DYKES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
186 W BARBEE ST, COLUMBIA, KY 42728-2230
(727) 373-8358
Mailing address
186 W BARBEE ST, COLUMBIA, KY 42728-2230
(727) 373-8358

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4007219
KY
376K00000X
Nurse's Aide
50210338
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4007219
KY
05
50210338
KY
Enumeration date
05/05/2020
Last updated
11/13/2023
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