MEDICARE: MRS. PAULA DENISE DICKSON

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3747P1801X	Personal Care Attendant
2	374U00000X	Home Health Aide
3	376J00000X	Homemaker
4	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1164716684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAULA DENISE DICKSON

Provider Business Mailing Address
First Line	:	3165 EASTVIEW RD
Second Line	:
City	:	EAST HELENA
State	:	MT
Zip	:	59635-3042
Country	:	US
Telephone Number	:	406-438-3220
Fax Number	:

Provider Business Practice Location Address
First Line	:	3165 EASTVIEW RD
Second Line	:
City	:	EAST HELENA
State	:	MT
Zip	:	59635-3042
Country	:	US
Telephone Number	:	406-438-3220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2011
Last Update Date	:	06/01/2011

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