MEDICARE: AIMEE E DICKSON MSN, APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	F02250768	GA
2	163W00000X	Registered Nurse	RN289764	GA

General Provider Information

NPI Number	:	1639963028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMEE E DICKSON MSN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	130 RIVERSTONE TER STE 102
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30114-1702
Country	:	US
Telephone Number	:	470-863-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1498 JESSE JEWELL PKWY SE STE C
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3874
Country	:	US
Telephone Number	:	770-744-4806
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2025
Last Update Date	:	12/10/2025

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