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Individual

KIMBERLY BICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1201 MICHIGAN AVE, STE 140, LOGANSPORT, IN 46947-1530
(574) 753-1462
(574) 753-1465
Mailing address
1201 MICHIGAN AVE, STE 140, LOGANSPORT, IN 46947-1530
(574) 753-1462
(574) 753-1465

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71004652A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000837494
ANTHEM PROVIDER NUMBER
IN
01
000000869195
ANTHEM
IN
05
201196430
IN
Enumeration date
09/23/2013
Last updated
12/09/2015
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