Healthcare Provider Details

I. General information

NPI: 1114793791
Provider Name (Legal Business Name): JILL ANN BICKFORD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 COMMERCE WAY STE 100
PORTSMOUTH NH
03801-3244
US

IV. Provider business mailing address

111 NEW HAMPSHIRE AVE STE 2
PORTSMOUTH NH
03801-2864
US

V. Phone/Fax

Practice location:
  • Phone: 603-441-1075
  • Fax: 603-294-1090
Mailing address:
  • Phone: 330-947-6021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number051935-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: