MEDICARE: KIMBERLY DICKSON

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	174400000X	Specialist	346	VA

General Provider Information

NPI Number	:	1881550341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY DICKSON

Provider Business Mailing Address
First Line	:	7151 MARECAGE CT
Second Line	:
City	:	NEW KENT
State	:	VA
Zip	:	23124-3122
Country	:	US
Telephone Number	:	804-501-8206
Fax Number	:

Provider Business Practice Location Address
First Line	:	6501 MECHANICSVILLE TPKE STE 102
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-3698
Country	:	US
Telephone Number	:	804-501-8206
Fax Number	:

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

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	03/06/2026

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Directions to “ KIMBERLY DICKSON ” Practice Location

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