Provider Demographics
NPI:1366507584
Name:DICKEY, JOAN MARIE (RN, FNP)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:MARIE
Last Name:DICKEY
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6622 OLD SETTLERS RD
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-9116
Mailing Address - Country:US
Mailing Address - Phone:704-843-5033
Mailing Address - Fax:704-843-6450
Practice Address - Street 1:6705 WYCLIFFE AVE.
Practice Address - Street 2:JAARS HEALTH SERVICES
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-0248
Practice Address - Country:US
Practice Address - Phone:704-843-6222
Practice Address - Fax:704-843-6450
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104518363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC201219OtherPRESCRIBERS NUMBER