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NPI Code Detail

MEDICARE: TIFFANY LYNN DICKINSON

MEDICARE: TIFFANY LYNN DICKINSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation PractitionerNV

General Provider Information

NPI Number : 1033519384
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY LYNN DICKINSON
Provider Business Mailing Address
First Line : 533 LAWNDALE PL
Second Line :
City : SPRING CREEK
State : NV
Zip : 89815-6157
Country : US
Telephone Number : 775-389-0337
Fax Number :
Provider Business Practice Location Address
First Line : 6889 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-4687
Country : US
Telephone Number : 702-434-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2014
Last Update Date : 08/22/2014

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Directions to “ TIFFANY LYNN DICKINSON ” Practice Location

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