| Mary Dickerson, CRNP | |
| 30207 Frankford School Rd, Frankford, DE 19945-2616 | |
| (302) 732-3800 | |
| (302) 732-6016 | 
| Full Name | Mary Dickerson | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 30207 Frankford School Rd, Frankford, Delaware | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1689005225 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 163WS0200X | Registered Nurse - School | L-10023320 (Delaware) | Secondary | 
| 363LF0000X | Nurse Practitioner - Family | AC003935 (Maryland) | Primary | 
| Entity Name | Privia Care Center Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1164874426 PECOS PAC ID: 3274801139 Enrollment ID: O20170619000055 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mary Dickerson, CRNP 30207 Frankford School Rd, Frankford, DE 19945-2616 Ph: (302) 732-3800 | Mary Dickerson, CRNP 30207 Frankford School Rd, Frankford, DE 19945-2616 Ph: (302) 732-3800 | 
| Jeffrey Allen Stevens Jr.,  Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 32171 Gum Rd, Frankford, DE 19945 Phone: 302-519-6824 | |
| Mrs. Marsha L Shull, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 34314 Pyle Center Rd, Frankford, DE 19945 Phone: 302-732-9512 | |
| Kimberly Crockett Brasure, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 35998 Zion Church Rd Unit 1, Frankford, DE 19945 Phone: 302-278-0093 Fax: 302-278-0096 |