Provider Demographics
NPI:1205210598
Name:BICKERTON, JOANNE KATHLEEN
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:KATHLEEN
Last Name:BICKERTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:KATHLEEN
Other - Last Name:STEGMAIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:3025 SCIENCE PARK DR
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7333
Mailing Address - Country:US
Mailing Address - Phone:440-341-8767
Mailing Address - Fax:
Practice Address - Street 1:3025 SCIENCE PARK DR
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7333
Practice Address - Country:US
Practice Address - Phone:216-445-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17741-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health