Provider Demographics
NPI:1134275381
Name:DICKEY, NANCY A B (RD)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:A B
Last Name:DICKEY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14024 DUNBAR CT
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7753
Mailing Address - Country:US
Mailing Address - Phone:952-423-6039
Mailing Address - Fax:
Practice Address - Street 1:14024 DUNBAR CT
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7753
Practice Address - Country:US
Practice Address - Phone:952-423-6039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN716381133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered