Tibli Olandrus Dickson, MANAGER

Nursing Home Administrator · Champlin, MN

Individual Active NPI

NPI number 1003615030

Practice location

7400 122ND Ave N
Champlin, MN 55316-2127
Phone
(612) 865-6220

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NPI record

NPI
1003615030
Entity type
Individual (Type 1)
Enumeration date
March 11, 2025
Last updated
March 11, 2025
Certified
March 11, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Nursing Home Administrator Primary 376G00000X — —

About Tibli Dickson

Tibli Olandrus Dickson, MANAGER is a healthcare provider registered in the NPI registry with the primary taxonomy Nursing Home Administrator (code 376G00000X). The practice location is 7400 122ND Ave N, Champlin, MN 55316-2127. The NPI number 1003615030 was assigned on March 11, 2025 and the record was last updated on March 11, 2025.

Frequently asked questions

What is the NPI number of Tibli Olandrus Dickson, MANAGER?

The NPI number is 1003615030.

What is the phone number of Tibli Dickson?

The phone number listed for the practice location is (612) 865-6220.

Where is Tibli Dickson located?

7400 122ND Ave N, Champlin, MN 55316-2127.

What is the taxonomy code for Tibli Dickson?

The primary taxonomy code is 376G00000X – Nursing Home Administrator.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.