| NPI | 1063075646 |
|---|---|
| Former Name | KELSEY ANN DICKERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 343973) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 720365) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2020-01-30 |