Provider Demographics
NPI:1336891878
Name:DICKEY, ANNE L
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:L
Last Name:DICKEY
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 1:4353 W HUNTERS RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-8707
Mailing Address - Country:US
Mailing Address - Phone:317-902-1953
Mailing Address - Fax:
Practice Address - Street 1:4353 W HUNTERS RIDGE LN
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-8707
Practice Address - Country:US
Practice Address - Phone:317-902-1953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered