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General NPI Number Information
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NPI Number | 1386006773
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Entity Type | Individual
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Provider Name | BETSY DICKSON
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Gender | Female
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 1300 ANNE ST NW
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City | BEMIDJI
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State | MN
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Zip | 56601-5103
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Country | US
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Telephone | 218-751-5430
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Fax |
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Provider Business Mailing Address
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Address Line | 3042 BIRCHMONT DR NE
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City | BEMIDJI
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State | MN
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Zip | 56601-4303
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Country | US
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Telephone | 218-779-1665
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 67184
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | DR.0069160
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License Number State | CO
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