Provider Demographics
NPI:1033787338
Name:DICKINSON, SABRINA NICHOLE
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:NICHOLE
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 413
Mailing Address - Street 2:
Mailing Address - City:SURREY
Mailing Address - State:ND
Mailing Address - Zip Code:58785-0413
Mailing Address - Country:US
Mailing Address - Phone:701-509-0655
Mailing Address - Fax:
Practice Address - Street 1:203 2ND ST SE
Practice Address - Street 2:APT 2
Practice Address - City:SURREY
Practice Address - State:ND
Practice Address - Zip Code:58785
Practice Address - Country:US
Practice Address - Phone:701-509-0655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant