Laschae Dickerson
Individual provider Active NPI Driver · Gretna, VA
NPI 1639695877 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1639695877
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 192 Discovery Rd
Gretna, VA 24557-4717 - Phone
- (434) 728-2083
- NPI assigned
- Aug 18, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
192 Discovery Rd
Gretna, VA 24557-4717
Mailing address
192 Discovery Rd
Gretna, VA 24557-4717
Phone (434) 728-2083
Other providers in Gretna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 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.