National Provider Identifier Database

TIBLI O DICKSON, MANAGER – NPI #1003615030
Nursing Home Administrator

An individual, often licensed by the state, who is responsible for the management of a nursing home.


Contact Information

TIBLI O DICKSON, MANAGER
7400 122ND AVE N
CHAMPLIN, MN55316-2127
Phone: 612-865-6220
Fax:
Website:
Specialty Taxonomy Code
* Nursing Home Administrator 376G00000X

* Indicates primary specialty

NPI Profile & details for TIBLI O DICKSON

NPI Number 1003615030
Credentials MANAGER
Entity Individual
Enumeration date 03/11/2025
Last updated 03/11/2025 - More than a year ago
Sole proprietor1 No
Identifiers n/a
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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