KAREN DICKERSON PA-C NPI 1760597462

NPI Information

NPI: 1760597462
Provider Name: KAREN DICKERSON, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
1352 E CENTER ST
POCATELLO, ID
ZIP 83201
Phone: (208) 234-2001
Get Directions

Karen Dickerson, PA-C is a medical physician assistant in Pocatello, ID. Karen Dickerson, PA-C NPI is 1760597462. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1352 E CENTER ST
POCATELLO, ID
ZIP 83201-734
Phone: (208) 234-2001
Fax: (208) 232-2195

The enumeration date for this NPI number is 8/20/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA566	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1667215	MEDICARE ID-TYPE UNSPECIFIED	IDAHO	CIGNA MEDICARE
2	Q56435	MEDICARE UPIN	IDAHO
3	8073207000	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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