Provider Demographics
NPI:1073655833
Name:DICKSON, NANCY ANN (BSN, MS, CRNA)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:DICKSON
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Gender:F
Credentials:BSN, MS, CRNA
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Mailing Address - Street 1:PO BOX 1128
Mailing Address - Street 2:9830 N BAR BOOT RANCH RD
Mailing Address - City:DOUGLAS
Mailing Address - State:AZ
Mailing Address - Zip Code:85608-1128
Mailing Address - Country:US
Mailing Address - Phone:520-824-3121
Mailing Address - Fax:520-824-3221
Practice Address - Street 1:2174 W OAK AVE
Practice Address - Street 2:SOUTHEAST AZ MEDICAL CENTER
Practice Address - City:DOUGLAS
Practice Address - State:AZ
Practice Address - Zip Code:85607-6003
Practice Address - Country:US
Practice Address - Phone:520-364-7931
Practice Address - Fax:520-364-2551
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
AZRN088338367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered