| Doctor Name: | MS. KASSANDRA A DICKENS |
| NPI Number: | 1871890301 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | R163196 |
| Business Practice Address: | 1701 Twin Springs Rd Halethorpe, MD - 212273553 |
| Business Phone Number: | 4107375744 |
| Business Fax Number: | 4107375002 |
| Mailing Address: | 1701 Twin Springs Rd, HALETHORPE |
| State: | MD |
| Postal Code: | 212273553 |
| Phone Number: | 4107375744 |
| Fax Number: | 4107375002 |
| NPI Enumeration Date: | 02/18/2011 |
| NPI Last Update Date: | 06/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R163196 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |