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

Mr. Charles Earl Dickerson Jr., CRNA

Individual provider Registered Nurse · NPI 1558701292

Mr. Charles Earl Dickerson Jr., CRNA is a Registered Nurse in Jacksonville, Florida. Licensed in California. Registered with an NPI since 2013.

Licensed in
CA
In the registry since
2013
Specialties on file
2
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

2005 Knight Ln Bldg H Navmedsupcom Attn: Med Staff Services
Jacksonville, FL 32212-0140
Phone: (619) 532-6684
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 4405 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 840135 (CA)

Record details

NPI number1558701292
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedJune 26, 2013
Last updated in NPPESJune 26, 2013

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