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NPI Code Detail

MEDICARE: BARBARA EVETTE DICKINSON LPN

MEDICARE:   BARBARA EVETTE DICKINSON  LPN
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
1164W00000XLicensed Practical NursePN112921OH

General Provider Information

NPI Number : 1831426212
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA EVETTE DICKINSON LPN
Provider Business Mailing Address
First Line : 17111 MAPLE HEIGHTS BLVD
Second Line :
City : MAPLE HEIGHTS
State : OH
Zip : 44137-2650
Country : US
Telephone Number : 216-712-8902
Fax Number :
Provider Business Practice Location Address
First Line : 17111 MAPLE HEIGHTS BLVD
Second Line :
City : MAPLE HEIGHTS
State : OH
Zip : 44137-2650
Country : US
Telephone Number : 216-712-8902
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2009
Last Update Date : 11/16/2009

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Directions to “ BARBARA EVETTE DICKINSON LPN” Practice Location

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