Kanisha Conrad Dickens, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

59949 Issued in NC

Practice address

12 Moonstone CT
Durham, NC 27703-2682

Phone

(866) 654-1113

Fax

(919) 439-0222

NPI assigned

Nov 1, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1659625499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MOONSTONE CT",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277031543",
            "telephone_number": "866-654-1113",
            "fax_number": "919-439-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 MOONSTONE CT",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277032682",
            "telephone_number": "866-654-1113",
            "fax_number": "919-439-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "KANISHA",
        "middle_name": "CONRAD",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "59949",
            "primary": true
        },
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": "NC",
            "license": "FCL-032-122",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dice Chiropractic Wellness
• Dice Health PLLC
• Megan Howerter Dice, PA-C
• Bryan Dicillo, DC
• Erica Dickens
• Betsy Dickerson, NP-C
• Lateesha Nicole Dickerson, MSW, LCSWA
• Averie Dickinson
• Bridget Dickinson, CNS
• Lily Mae Dickinson, MSW

• Licensed Practical Nurse in Durham, NC
• Providers in Durham, NC by specialty
• Licensed Practical Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.