MS. KASSANDRA A DICKENS CRNP NPI 1871890301

NPI Information

NPI: 1871890301
Provider Name: MS. KASSANDRA A DICKENS, CRNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1417 WINTER PINE TRL
SEVERN, MD
ZIP 21144
Phone: (301) 675-6471
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MS. Kassandra A Dickens, CRNP is a psychiatric/mental health nurse practitioner in Severn, MD with 15 years of experience. MS. Kassandra A Dickens, CRNP NPI is 1871890301. 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:

1417 WINTER PINE TRL
SEVERN, MD
ZIP 21144-506
Phone: (301) 675-6471
Fax: (410) 832-5766

The NPI 1871890301 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/18/2011 and was last updated on 9/21/2022.

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	363LF0000X	Nurse Practitioner	Family	R163196	MARYLAND	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	R163196	MARYLAND	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	9115660	OTHER	MARYLAND	AETNA PPO
2	6602616	OTHER	MARYLAND	AETNA HMO
3	246893	OTHER	MARYLAND	EHP/PRIORITY PARTNERS
4	P00936839	OTHER	MARYLAND	RAILROAD MEDICARE
5	0114	OTHER	MARYLAND	CAREFIRST BCBS BLUECHOICE
6	553221300	MEDICAID	MARYLAND
7	97285701	OTHER	MARYLAND	CAREFIRST BCBS OF MD

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: 5/5/2024

NPI Synchronization or Removal

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