Individual
MRS. NICOLE RAYANNE BIKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
825 BARRET AVE, LOUISVILLE, KY 40204-1743
(502) 540-7200
(502) 540-7210
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3013122
KY
363LF0000X
Family Nurse Practitioner
71004231A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
178410004
MEDICARE PTAN
IN
01
—
178420005
MEDICARE PTAN
IN
05
—
201127530
—
IN
05
—
7100591230
—
KY
Enumeration date
10/12/2012
Last updated
10/12/2020
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