Healthcare Provider Details

I. General information

NPI: 1841109105
Provider Name (Legal Business Name): CAROLINE DICKER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

882 GARRISONVILLE RD
STAFFORD VA
22554-3907
US

IV. Provider business mailing address

2250 CLARENDON BLVD APT 1512
ARLINGTON VA
22201-3344
US

V. Phone/Fax

Practice location:
  • Phone: 540-318-6464
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: