Provider Demographics
NPI:1487880266
Name:DICKSON, GABRIELLE LYNN (RN)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:LYNN
Last Name:DICKSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 WHIMS RD
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8577
Mailing Address - Country:US
Mailing Address - Phone:614-920-1795
Mailing Address - Fax:614-920-1795
Practice Address - Street 1:6310 WHIMS RD
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-8577
Practice Address - Country:US
Practice Address - Phone:614-920-1795
Practice Address - Fax:614-920-1795
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-06
Last Update Date:2009-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN299536163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health