Connie Gail Dickson, APRN

Individual provider Active NPI Family Nurse Practitioner · Franklin, KY

NPI 1306114640 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1306114640
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
3007222 (KY)
Practice address
208 S Main St
Franklin, KY 42134-2116
Phone
(270) 781-6477
Fax
(270) 647-6479
NPI assigned
Dec 1, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
3007222KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corp, Inc. Family Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3007222 KY Yes

Addresses

Primary practice location

208 S Main St
Franklin, KY 42134-2116

Mailing address

201 Park St
Bowling Green, KY 42101-1759
Phone (270) 781-6477

Other identifiers

IdentifierTypeStateIssuer
7100187890MedicaidKY

Other providers in Franklin, KY

All providers in Franklin, KY · Family Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.