Individual provider · Type 1 NPI
Tibli Olandrus Dickson, MANAGER
Nursing Home Administrator · Champlin, MN
NPI number
1003615030
Active
Practice location
7400 122nd Ave N
Champlin, MN 55316-2127
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nursing Home Administrator Primary | 376G00000X | None listed |
Nursing Home Administrator: An individual, often licensed by the state, who is responsible for the management of a nursing home.
2 other providers at this address
About NPI 1003615030
Tibli Olandrus Dickson, MANAGER's National Provider Identifier is 1003615030, issued on Mar 11, 2025. The primary taxonomy on file is Nursing Home Administrator (376G00000X), and the practice location is in Champlin, MN. The record was last updated on Mar 11, 2025.