Healthcare Provider Details

I. General information

NPI: 1427344985
Provider Name (Legal Business Name): KRISTIN LYNN DICKSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 S MEBANE ST
BURLINGTON NC
27215-6235
US

IV. Provider business mailing address

4095 BATTLEGROUND AVE
GREENSBORO NC
27410-8410
US

V. Phone/Fax

Practice location:
  • Phone: 336-560-9335
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2014-01256
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: