Provider Demographics
NPI:1891528253
Name:DICKSON, ALEXA ANNE (FNP)
Entity type:Individual
Prefix:MRS
First Name:ALEXA
Middle Name:ANNE
Last Name:DICKSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:ANNE
Other - Last Name:SATHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 WHITCHER ST NE STE 460
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1171
Mailing Address - Country:US
Mailing Address - Phone:770-427-7389
Mailing Address - Fax:
Practice Address - Street 1:55 WHITCHER ST NE STE 460
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1171
Practice Address - Country:US
Practice Address - Phone:770-427-7389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN288264363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner