Dickerson, Nancy M

Dickerson, Nancy M is an individual health care provider with primary practice located at 3960 Coon Rapids Blvd Nw Suite101, Coon Rapids MN 55433-2569. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Dickerson, Nancy M can be contacted via phone (763) 236-9236.

Contact Information

Primary practice address
3960 Coon Rapids Blvd Nw Suite101 Coon Rapids MN 55433-2569
Phone: (763) 236-9236
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 33867 Minnesota

Profile Details

NPI number 1053378851
LBN Legal business name Dickerson, Nancy M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Nov 10th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053378851 NPPES
Minnesota MEDICAID 239802800

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