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General NPI Number Information
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NPI Number | 1790316115
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Entity Type | Individual
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Provider Name | LISA RENEE DICKEY APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/04/2020
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 101 E 15TH AVE
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City | GULF SHORES
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State | AL
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Zip | 36542-3501
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Country | US
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Telephone | 251-967-7816
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Fax | 251-967-7832
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Provider Business Mailing Address
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Address Line | PO BOX 689022
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City | FRANKLIN
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State | TN
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Zip | 37068-9022
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Country | US
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Telephone | 615-465-7390
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Fax | 615-628-6877
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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 | 23609
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-203666
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License Number State | AL
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