Provider Demographics
NPI:1699508077
Name:BIKOWITZ, NICOLE (FNP-C)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BIKOWITZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 TIMBERMILL LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-2233
Mailing Address - Country:US
Mailing Address - Phone:386-748-0820
Mailing Address - Fax:
Practice Address - Street 1:8351 WESTPORT RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-5901
Practice Address - Country:US
Practice Address - Phone:904-317-8811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11034917363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily