Provider Demographics
NPI:1093797938
Name:DICKEY, ROSE MARIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:MARIE
Last Name:DICKEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 FLAGMORE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-4233
Mailing Address - Country:US
Mailing Address - Phone:281-579-1593
Mailing Address - Fax:281-579-1593
Practice Address - Street 1:1146 FLAGMORE DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-4233
Practice Address - Country:US
Practice Address - Phone:281-579-1593
Practice Address - Fax:281-579-1593
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX511512363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS60103Medicare UPIN
TX8E0003Medicare PIN