Healthcare Provider Details

I. General information

NPI: 1417482936
Provider Name (Legal Business Name): LAURA JEAN BICKFORD DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 SOKOKIS TRL
EAST WATERBORO ME
04030-5400
US

IV. Provider business mailing address

43 SOKOKIS TRL
EAST WATERBORO ME
04030-5400
US

V. Phone/Fax

Practice location:
  • Phone: 207-247-6742
  • Fax:
Mailing address:
  • Phone: 207-247-6742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP171021
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: