Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN2314760 | MA |
N | 363LP0200X | Nurse Practitioner - Pediatrics | SP012531 | PA |
NPI | 1023354198 |
---|---|
Provider Name | Mrs. Lindsay Madeline Dicker |
First Address | Peabody, MA 01960-7938 |
Second Address | Peabody, MA 01960-7938 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2012 |
Last Update Date | 17/03/2018 |