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Individual

AMY R. DICKENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
208 HEALTH CARE DR, PENNINGTON GAP, VA 24277-2854
(276) 546-4566
Mailing address
6 6TH ST STE 256, BRISTOL, TN 37620-2257
(423) 573-1502

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001224944
VA
363LF0000X
Family Nurse Practitioner
0024172952
VA
363LF0000X
Family Nurse Practitioner
20539
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024172952
VA

Other

Enumeration date
07/02/2015
Last updated
02/14/2023
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