| NPI | 1568501096 |
|---|---|
| Former Name | TINA MARIE DICKINSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 8128) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 129376) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2023-12-01 |