Provider Demographics
NPI:1871889568
Name:BICKELL, ELIZABETH ERIN (PA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ERIN
Last Name:BICKELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 JEFFERSON ST
Mailing Address - Street 2:SUITE 113
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-3710
Mailing Address - Country:US
Mailing Address - Phone:910-642-3356
Mailing Address - Fax:
Practice Address - Street 1:800 JEFFERSON ST
Practice Address - Street 2:SUITE 113
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-3710
Practice Address - Country:US
Practice Address - Phone:910-642-3356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001002890363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical