MEDICARE: MS. JILL ANN DICKINSON P.T.

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
1	2251N0400X	Neurology Physical Therapist	0551	NV
2	2251P0200X	Pediatric Physical Therapist	0551	NV
3	2251X0800X	Orthopedic Physical Therapist	0551	NV

General Provider Information

NPI Number	:	1417042128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JILL ANN DICKINSON P.T.

Provider Business Mailing Address
First Line	:	7451 GRANITE RIDGE CT
Second Line	:
City	:	WASHOE VALLEY
State	:	NV
Zip	:	89704-8576
Country	:	US
Telephone Number	:	775-830-1782
Fax Number	:	775-849-1248

Provider Business Practice Location Address
First Line	:	7451 GRANITE RIDGE CT
Second Line	:
City	:	WASHOE VALLEY
State	:	NV
Zip	:	89704-8576
Country	:	US
Telephone Number	:	775-830-1782
Fax Number	:	775-849-1248

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	09/11/2025

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