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Individual

TERESA L DICKENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RNC WHNP

Contact information

Practice address
1000 E PRIMROSE ST, SUITE 400, SPRINGFIELD, MO 65807-5154
(417) 269-7900
(417) 269-7990
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 875-3000

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
13277
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821020801
MO
05
424953107
MO
Enumeration date
07/07/2006
Last updated
09/22/2016
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