Provider Demographics
NPI:1639660772
Name:DICKINSON, MICHELE E (BSN RN)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:E
Last Name:DICKINSON
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:E
Other - Last Name:BILLINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44150 W MARICOPA CASA GRANDE HWY
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-5900
Mailing Address - Country:US
Mailing Address - Phone:520-568-5100
Mailing Address - Fax:520-568-5110
Practice Address - Street 1:44150 W MARICOPA CASA GRANDE HWY
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-5900
Practice Address - Country:US
Practice Address - Phone:520-568-5100
Practice Address - Fax:520-568-5110
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN126246163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool