Individual
KAREN KENNEY DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1930 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-4708
(763) 746-9583
Mailing address
1930 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-4708
(763) 746-9583
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
31904
MN
2084P0805X
Geriatric Psychiatry Physician
31904
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0804006
PREFERRED ONE
MN
01
—
0T553DI
BCBS OF MN
MN
01
—
101741
U-CARE
MN
05
—
267588900
—
MN
01
—
HP20455
HEALTH PARTNERS
MN
Enumeration date
07/09/2006
Last updated
01/03/2014
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