Basic Information
| Provider Information | |||||||||
| NPI: | 1891037016 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BICKEL | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | RICE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | AGPCNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 79 DEER PATH | ||||||||
| Address2: | |||||||||
| City: | KENNETT SQUARE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193482345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2672572280 | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 CONTINENTAL DR | ||||||||
| Address2: | SUITE 406 | ||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197134306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3023682630 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2013 | ||||||||
| LastUpdateDate: | 03/26/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | LB-0000278 | DE | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.