MEDICARE: SEAN O'NEAL DICKSON RN

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	163WC0200X	Critical Care Medicine Registered Nurse	1-198070	AL

General Provider Information

NPI Number	:	1972457679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN O'NEAL DICKSON RN

Provider Business Mailing Address
First Line	:	1231 LAKE FOREST CIR
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-1304
Country	:	US
Telephone Number	:	205-777-2492
Fax Number	:

Provider Business Practice Location Address
First Line	:	1231 LAKE FOREST CIR
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-1304
Country	:	US
Telephone Number	:	205-777-2492
Fax Number	:

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

Provider Enumeration Date	:	02/21/2026
Last Update Date	:	02/21/2026

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