Provider Demographics
NPI:1740163336
Name:KIMBERLY RICE BICKEL NURSE PRACTITIONER IN ADULT HEALTH PLLC
Entity type:Organization
Organization Name:KIMBERLY RICE BICKEL NURSE PRACTITIONER IN ADULT HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:RICE
Authorized Official - Last Name:BICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:267-257-2280
Mailing Address - Street 1:72 KENOZIA LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SHOKAN
Mailing Address - State:NY
Mailing Address - Zip Code:12481-5109
Mailing Address - Country:US
Mailing Address - Phone:267-257-2280
Mailing Address - Fax:
Practice Address - Street 1:99 GOLDEN HILL DR
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-6442
Practice Address - Country:US
Practice Address - Phone:267-257-2280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty