Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Edward Dickerson, DNAP

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1013659960

Jacob Edward Dickerson, DNAP is a Certified Registered Nurse Anesthetist (CRNA) in Tahlequah, Oklahoma. Qualified in 2022, 4 years ago. Practices with Cherokee Nation, a 448-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
4
Licensed in
OK
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone: (918) 458-3100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 901 S National Ave, Springfield, MO 65897-0001 — (417) 836-5000

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 208980 (OK)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1013659960
Entity typeIndividual (Type 1)
GenderMale
Credentials DNAP
Sole proprietorYes
NPI enumeratedApril 11, 2022
Last updated in NPPESJuly 10, 2022
Certification dateJuly 10, 2022
Mailing address21781 E 785 Rd, Welling, OK 74471-2035

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Cherokee Nation — 448 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Tahlequah