Provider Demographics
NPI:1811504228
Name:DICKSON, CINDY ANN
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:ANN
Last Name:DICKSON
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 1:260 E WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-2155
Mailing Address - Country:US
Mailing Address - Phone:740-417-3477
Mailing Address - Fax:
Practice Address - Street 1:260 E WILLIAM ST
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-2155
Practice Address - Country:US
Practice Address - Phone:740-417-3477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker