Provider Demographics
NPI:1164136420
Name:DICKINSON, ABBY JEAN (RN)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:JEAN
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6729 WASHBURN AVE S
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-1925
Mailing Address - Country:US
Mailing Address - Phone:612-719-2952
Mailing Address - Fax:
Practice Address - Street 1:6729 WASHBURN AVE S
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-1925
Practice Address - Country:US
Practice Address - Phone:612-719-2952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2159373163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse