1689524324 NPI number — LORI DICKENS MSN, PMHNP-BC, APRN

Table of content: LORI DICKENS MSN, PMHNP-BC, APRN (NPI 1689524324)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689524324 NPI number — LORI DICKENS MSN, PMHNP-BC, APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DICKENS
Provider First Name:
LORI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN, PMHNP-BC, APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689524324
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/02/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1217 BETHLEHEM RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KNIGHTDALE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27545-9325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-971-7386
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 NW MAYNARD RD STE 140
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27513-8707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
984-341-0531
Provider Business Practice Location Address Fax Number:
919-704-3674
Provider Enumeration Date:
02/02/2026

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  5023887 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com