Provider Demographics
NPI:1114793791
Name:BICKFORD, JILL ANN (APRN)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:ANN
Last Name:BICKFORD
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 NEW HAMPSHIRE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-2864
Mailing Address - Country:US
Mailing Address - Phone:330-947-6021
Mailing Address - Fax:
Practice Address - Street 1:215 COMMERCE WAY STE 100
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-3244
Practice Address - Country:US
Practice Address - Phone:603-441-1075
Practice Address - Fax:603-294-1090
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH051935-23363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health