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General NPI Number Information
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NPI Number | 1427195023
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Entity Type | Individual
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Provider Name | SHARON P. DICKS NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 198 COLLEGE HILL RD TB RUDD HEALTH CENTER
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City | CLINTON
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State | NY
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Zip | 13323
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Country | US
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Telephone | 315-859-4111
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Fax | 315-859-4963
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Provider Business Mailing Address
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Address Line | 57 IMPERIAL DR
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City | NEW HARTFORD
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State | NY
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Zip | 13413-3222
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Country | US
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Telephone | 315-737-7950
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 330571-1
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License Number State | NY
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