Provider Demographics
NPI:1417042128
Name:DICKINSON, JILL ANN (PT)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:ANN
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7451 GRANITE RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WASHOE VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89704-8576
Mailing Address - Country:US
Mailing Address - Phone:775-830-1782
Mailing Address - Fax:775-849-1248
Practice Address - Street 1:7451 GRANITE RIDGE CT
Practice Address - Street 2:
Practice Address - City:WASHOE VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89704-8576
Practice Address - Country:US
Practice Address - Phone:775-830-1782
Practice Address - Fax:775-849-1248
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV05512251N0400X, 2251P0200X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic