Provider Demographics
NPI:1467572370
Name:DICKINSON, CAROL F (FNP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:F
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 LANESBORO RD
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:MA
Mailing Address - Zip Code:01225-9700
Mailing Address - Country:US
Mailing Address - Phone:413-743-5850
Mailing Address - Fax:413-684-5251
Practice Address - Street 1:165 TOR CT
Practice Address - Street 2:HILLCREST CAMPUS OCCUPATIONAL HEALTH DEPT
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-3001
Practice Address - Country:US
Practice Address - Phone:413-447-3036
Practice Address - Fax:413-445-9571
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA141312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA141312OtherMASS LICENSE