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General NPI Number Information
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NPI Number | 1639131675
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Entity Type | Individual
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Provider Name | JAMIE DICKERSON ARNP
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Gender | Female
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 03/26/2014
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Provider Practice Location Address
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Address Line | 10 CADILLAC DRIVE SUITE 350 OPTUM/UHG
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City | BRENTWOOD
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State | TN
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Zip | 37027
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Country | US
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Telephone | 561-282-8185
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Fax |
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Provider Business Mailing Address
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Address Line | 861 42ND AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33703-4638
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Country | US
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Telephone |
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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 | 1741432
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License Number State | FL
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