Individual
VANESSA MARIE DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
11035 E 38TH ST, TULSA, OK 74146-2528
(918) 344-7007
Mailing address
11035 E 38TH ST, TULSA, OK 74146-2528
(918) 344-7007
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
213971
OK
Other
Enumeration date
11/29/2024
Last updated
11/29/2024
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