Jessica Dickman
Nurse Practitioner, Family in Saint Louis, MO. Individual provider (NPI-1).
NPI number1669940656
StatusActive
Last updated in NPPESOct 21, 2020
Details
- NPI
- 1669940656
- Entity type
- Individual (NPI-1)
- Name
- Jessica Dickman
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 7, 2018
- Certification date
- Oct 21, 2020
- Last updated
- Oct 21, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 2008033582 | MO | Yes |
Practice location
1035 Bellevue Ave Ste 500Saint Louis, MO 63117-1843
Phone 314-925-4773
Mailing address
Po Box 955534Saint Louis, MO 63195-1982
Other practice locations
3635 Vista Ave
Saint Louis, MO 63110-2539
Saint Louis, MO 63110-2539
Phone 314-577-8735
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