Vanessa Nicole Dickerson, RN
Individual provider Active NPI Registered Nurse · Fortuna, CA
NPI 1194467407 · NPPES record last updated Apr 9, 2022
Key facts
- NPI
- 1194467407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 95026270 (CA)
- Practice address
- 3490 Renner Dr
Fortuna, CA 95540-3105 - Phone
- (707) 740-5080
- NPI assigned
- Apr 8, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95026270 | CA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dickerson Solution | Registered Nurse | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 95026270 | CA | Yes |
Addresses
Primary practice location
3490 Renner Dr
Fortuna, CA 95540-3105
Mailing address
3490 Renner Dr
Fortuna, CA 95540-3105
Phone (707) 740-5080
Other providers in Fortuna, CA
- Danilo Santiago Dela Cruz
- Andrew Marcus Delgado
- Stephanie L Demara
- Dickerson Solution
- Dionysos Durand Dickerson
- Patricia Dillon
- Stephanie S Dittmer
- Mary Terese Dodd
- Tamara Smith Douglass
- Fannette Downie-Allman
All providers in Fortuna, CA · Registered Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.