Laura Renee Dickerson, DNP, FNP-BC is a
Nurse Practitioner - Family based in Byron, Illinois. Laura Renee Dickerson is licensed to practice in Illinois (license number 209.026248) and her current practice location is
404 W Blackhawk Dr Lowr Level, Byron, Illinois. She can be reached at her office (for appointments etc.) via phone at
(815) 904-1249.
NPI number for Laura Renee Dickerson is 1710694401 and her current mailing address is 404 W Blackhawk Dr Lowr Level, Byron, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1710694401.
Provider's Profile
Full Name | Laura Renee Dickerson |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 404 W Blackhawk Dr Lowr Level, Byron, Illinois |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1710694401
- Provider Enumeration Date: 11/01/2022
- Last Update Date: 12/27/2023
Medical Identifiers
Medical identifiers for Laura Renee Dickerson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1710694401 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | 041.428105 (Illinois) | Secondary |
363LF0000X | Nurse Practitioner - Family | 209.026248 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Laura Renee Dickerson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Laura Renee Dickerson, DNP, FNP-BC 404 W Blackhawk Dr Lowr Level, Byron, IL 61010-7500 Ph: (815) 904-1249 | Laura Renee Dickerson, DNP, FNP-BC 404 W Blackhawk Dr Lowr Level, Byron, IL 61010-7500 Ph: (815) 904-1249 |
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