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General NPI Number Information
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NPI Number | 1881550341
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Entity Type | Individual
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Provider Name | KIMBERLY DICKSON
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Gender | Female
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 6501 MECHANICSVILLE TPKE STE 102
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-3698
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Country | US
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Telephone | 804-501-8206
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Fax |
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Provider Business Mailing Address
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Address Line | 7151 MARECAGE CT
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City | NEW KENT
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State | VA
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Zip | 23124-3122
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Country | US
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Telephone | 804-501-8206
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 346
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License Number State | VA
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