| NPI | 1831728559 |
|---|---|
| Former Name | KRISTEN DICKERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 30024) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95014208) |
| Enumeration Date | 2020-04-04 |
| Last Update Date | 2023-07-05 |