Kelcie Dickerson, PA

NPI #1992105696 in Lyman, Wyoming

Provider Information

NPI Number: 1992105696
Entity Type: Individual
Name: Kelcie Dickerson, PA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Aug 29, 2014
Last Updated: Aug 29, 2014

Practice Location

Address: 3580 STATE HIGHWAY 414
City: Lyman
State: Wyoming
ZIP Code: 82937-0001
Phone: (307) 786-2042

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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