Natalie C Dickerson, LPN

Individual provider Active NPI Licensed Practical Nurse · Sharon, WI

NPI 1346513025 · NPPES record last updated Feb 10, 2012

Key facts

NPI
1346513025
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
31322-31 (WI)
Practice address
170 Seymour St
Sharon, WI 53585-9620
Phone
(262) 736-4876
Fax
(262) 736-4876
NPI assigned
Feb 10, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
31322-31WIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 31322-31 WI Yes

Addresses

Primary practice location

170 Seymour St
Sharon, WI 53585-9620

Mailing address

170 Seymour St
Sharon, WI 53585-9620
Phone (262) 736-4876

Other providers in Sharon, WI

All providers in Sharon, WI · Licensed Practical Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.