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Active NPI 1336699958 Individual Practitioner Female Practitioner

Mandy Marie Dickerson , NP

Nurse Practitioner • Port Huron, MI

Professional Overview & Biography Verified Profile Summary

Mandy Dickerson, NP is a registered healthcare professional specializing in Nurse Practitioner in Port Huron, MI. Practice services are available at 1321 STONE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1321 Stone
Bw Childrens Health Care

Port Huron, MI 48060

Telephone 8109841000

Specialty Benchmarks & Practice Insights

Comparative analytics for Nurse Practitioner in Port Huron, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 8.8 Yrs
State Avg: 10.8 Yrs
Regional Practice Density
22 Specialists

Practicing in Port Huron, MI (3626 Statewide)

Telehealth Adoption Rate
13.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-12-28
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

State License MI 4704275005

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1164498234

Doctor of Medicine (M.D.)

Sherri Klenczar , CPNP

Nurse Practitioner - Pediatrics

NPI 1588085716

Certified Pediatric Nurse Practitioner

Sharon Johnston , CPNP

Nurse Practitioner - Pediatrics

NPI 1841266095

Certified Pediatric Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

15 Historical Events
📍
Updated Practice Location October 02, 2024

Registered at 1321 STONE, BW CHILDRENS HEALTH CARE, PORT HURON, MI 48060 (Tel: 8109841000)

📍
Updated Business Mailing Address October 02, 2024

Registered at 1321 STONE STREET, PORT HURON, MI 48060 (Tel: 8109841000)

👤
Provider Name / Credentials Updated October 02, 2024

Recorded as MANDY DICKERSON, NP

📍
Updated Business Mailing Address December 28, 2020

Registered at 3621 S STATE ST, ANN ARBOR, MI 481081633 (Tel: 7346475299)

NPI Profile Active January 23, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location January 23, 2017

Registered at 6655 NEFF RD, MOUNT MORRIS, MI 48458 (Tel: 7349982161)

📍
Updated Business Mailing Address January 23, 2017

Registered at 3621 SOUTH STATE STREET, 700 KMS PLACE, ANN ARBOR, MI 48108 (Tel: 7349362047)

👤
Provider Name / Credentials Updated January 23, 2017

Recorded as MANDY LYON, NP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 23, 2017

Nurse Practitioner (License #4704275005 in MI)

NPI Profile Active October 06, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location October 06, 2016

Registered at 2502 S ROCHESTER RD, ROCHESTER HILLS, MI 483073817 (Tel: 2488525177)

📍
Updated Business Mailing Address October 06, 2016

Registered at 2502 S ROCHESTER RD, ROCHESTER HILLS, MI 483073817 (Tel: 2488525177)

👤
Provider Name / Credentials Updated October 06, 2016

Recorded as MANDY LYON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 06, 2016

Clinical Nurse Specialist (License #4704275005 in MI)

🟢
Initial NPI Registration & Enumeration October 06, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1336699958
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 06, 2016
Last Update: October 02, 2024
Sole Proprietor: No

Mailing Address

1321 Stone Street

Port Huron, MI 48060

Phone: 8109841000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.