Dickerson, Rebecca Rae

Dickerson, Rebecca Rae is an sole proprietor health care provider with primary practice located at 12060 County Line Rd Suite D, Madison AL 35756-2003. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Dickerson, Rebecca Rae can be contacted via phone (256) 232-0475.

Contact Information

Primary practice address
12060 County Line Rd Suite D Madison AL 35756-2003
Phone: (256) 232-0475
Fax: (256) 232-0429
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1-093181 Alabama
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 1-093181 Alabama

Profile Details

NPI number 1427290337
LBN Legal business name Dickerson, Rebecca Rae
Credentials CRNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 24th, 2009
Last updated Mar 12th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427290337 NPPES
Alabama MEDICAID 110708

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