Healthcare Provider Details

I. General information

NPI: 1952378705
Provider Name (Legal Business Name): FRANCES C BIDWELL ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4417 VESTAL PARKWAY EAST SUITE 301
VESTAL NY
13850-3556
US

IV. Provider business mailing address

346 GRAND AVE UNITED MEDICAL ASSOCIATES PC
JOHNSON CITY NY
13790-2580
US

V. Phone/Fax

Practice location:
  • Phone: 607-797-4496
  • Fax: 607-729-5995
Mailing address:
  • Phone: 607-729-8156
  • Fax: 607-729-3982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number301160
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: