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Individual

LYNN ELLEN DICUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
305 TYSON AVE, PARIS, TN 38242-4579
(731) 642-0025
(731) 644-0899
Mailing address
305 TYSON AVE, PARIS, TN 38242-4579
(731) 642-0025
(731) 644-0899

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
APN 5352
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3903166
TN
01
500011931
RAILROAD MEDICARE
Enumeration date
11/05/2005
Last updated
12/21/2009
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