Provider Demographics
NPI:1447851076
Name:DICKINSON, ROBERT JAMES (APRN)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:DICKINSON
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:JAMES
Other - Last Name:DICKINSON
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:APRN, PMHNP-BC
Mailing Address - Street 1:237 AMISTAD DR
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-1872
Mailing Address - Country:US
Mailing Address - Phone:412-853-4014
Mailing Address - Fax:
Practice Address - Street 1:1400 OLD DIXIE HWY
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-4190
Practice Address - Country:US
Practice Address - Phone:412-853-4014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9320091163WP0808X
FLAPRN11012664363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health