Provider Demographics
NPI:1972355857
Name:DICKENS, TASHAUNA R
Entity Type:Individual
Prefix:MRS
First Name:TASHAUNA
Middle Name:R
Last Name:DICKENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N MEDICAL DRIVE UNC SON-CH SON: CARRINGTON HALL
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7460
Mailing Address - Country:US
Mailing Address - Phone:919-966-4260
Mailing Address - Fax:
Practice Address - Street 1:120 N MEDICAL DR UNC-CH SON CARRINGTON HALL
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program