Provider Demographics
NPI:1588174163
Name:DICKENSON, ABBY D (APRN)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:D
Last Name:DICKENSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:LYNN
Other - Last Name:DEBUSK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:61 WHITCHER ST NE STE 4120
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1179
Mailing Address - Country:US
Mailing Address - Phone:770-424-9732
Mailing Address - Fax:770-421-0228
Practice Address - Street 1:61 WHITCHER ST NE STE 4120
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1179
Practice Address - Country:US
Practice Address - Phone:770-424-9732
Practice Address - Fax:770-421-0228
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23073363LF0000X
VA0024177599363LF0000X
GARN301503363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily