Individual
GENESIA DICKSON IRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10461 WALLACE ALLEY ST, KINGSPORT, TN 37663-3936
(423) 279-1400
(423) 279-1410
Mailing address
2756 BOB LITTLE RD, ELIZABETHTON, TN 37643-7222
(423) 202-2274
(423) 279-1410
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
22008
TN
Other
Enumeration date
12/15/2016
Last updated
12/15/2016
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