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General NPI Number Information
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NPI Number | 1366507584
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Entity Type | Individual
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Provider Name | JOAN MARIE DICKEY RN, FNP
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Gender | Female
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6705 WYCLIFFE AVE. JAARS HEALTH SERVICES
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City | WAXHAW
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State | NC
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Zip | 28173-0248
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Country | US
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Telephone | 704-843-6222
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Fax | 704-843-6450
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Provider Business Mailing Address
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Address Line | 6622 OLD SETTLERS RD
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City | WAXHAW
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State | NC
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Zip | 28173-9116
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Country | US
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Telephone | 704-843-5033
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Fax | 704-843-6450
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 104518
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License Number State | NC
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