Provider Demographics
NPI:1942614409
Name:BICK, JENNIFER (LM)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:BICK
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 6TH AVE S APT 4101
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-4463
Mailing Address - Country:US
Mailing Address - Phone:305-492-2288
Mailing Address - Fax:
Practice Address - Street 1:707 6TH AVE S APT 4101
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33460-4463
Practice Address - Country:US
Practice Address - Phone:305-492-2288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW280176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife