Individual provider · Type 1 NPI

Jonathan Grant Dicke

Student in an Organized Health Care Education/Training Program · Albuquerque, NM

NPI number 1013761147 Active

Practice location

MSC10 5600, 1 University Of New Mexico
Albuquerque, NM 87131-0001

Call (505) 272-2231 Map

Fax (505) 272-8098

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XRS2024-0060 (NM)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1013761147

Jonathan Grant Dicke's National Provider Identifier is 1013761147, issued on Apr 15, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Albuquerque, NM. The record was last updated on Jan 3, 2025.