Provider Demographics
NPI:1134962277
Name:DICKSON, KATHERINE ANN (DNP, MSN, BSN, RN)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ANN
Last Name:DICKSON
Suffix:
Gender:F
Credentials:DNP, MSN, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1882 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:PA
Mailing Address - Zip Code:16362-2506
Mailing Address - Country:US
Mailing Address - Phone:814-428-5696
Mailing Address - Fax:
Practice Address - Street 1:811 GRANDVIEW RD STE 100
Practice Address - Street 2:
Practice Address - City:OIL CITY
Practice Address - State:PA
Practice Address - Zip Code:16301-2077
Practice Address - Country:US
Practice Address - Phone:814-670-7950
Practice Address - Fax:814-671-7951
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP030145363LP0808X
PARN696824163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health