Provider Demographics
NPI:1437771953
Name:DICKENS, JAMES LAVELLE (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LAVELLE
Last Name:DICKENS
Suffix:
Gender:M
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 YOUNG ST STE 900
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202-5400
Mailing Address - Country:US
Mailing Address - Phone:940-300-3294
Mailing Address - Fax:
Practice Address - Street 1:1301 YOUNG ST STE 900
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75202-5400
Practice Address - Country:US
Practice Address - Phone:940-300-3294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP123770363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty