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

Mr. Tibli Olandrus Dickson, MANAGER

Individual provider Nursing Home Administrator · NPI 1003615030

Mr. Tibli Olandrus Dickson, MANAGER is a Nursing Home Administrator in Champlin, Minnesota. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

7400 122nd Ave N
Champlin, MN 55316-2127
Phone: (612) 865-6220
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nursing Home Administrator (primary) Taxonomy 376G00000X

Record details

NPI number1003615030
Entity typeIndividual (Type 1)
GenderMale
Credentials MANAGER
Sole proprietorNo
NPI enumeratedMarch 11, 2025
Last updated in NPPESMarch 11, 2025
Certification dateMarch 11, 2025