Healthcare Provider Details

I. General information

NPI: 1942118955
Provider Name (Legal Business Name): BRIDGET DICKINSON CNS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

316 STEEPLE RD
HOLLY SPRINGS NC
27540-8964
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-3450
  • Fax:
Mailing address:
  • Phone: 315-868-8237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number259374
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: