Individual
JAMES DAVIN DICKERSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
300 W BROADWAY, COUNCIL BLUFFS, IA 51503-9045
(712) 256-7511
Mailing address
300 W BROADWAY, COUNCIL BLUFFS, IA 51503-9045
(712) 256-7511
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
A108066
IA
Other
Enumeration date
06/13/2006
Last updated
07/08/2007
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