Bidwell, Alice Susan

Bidwell, Alice Susan is an sole proprietor health care provider with primary practice located at 11250 Roger Bacon Dr Suite 12, Reston VA 20190-5219. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Bidwell, Alice Susan can be contacted via phone (703) 424-0461.

Contact Information

Primary practice address
11250 Roger Bacon Dr Suite 12 Reston VA 20190-5219
Phone: (703) 424-0461
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 364SP0808X 0015000280 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult 364SP0809X 0015000280 Virginia

Profile Details

NPI number 1689753089
LBN Legal business name Bidwell, Alice Susan
Credentials Clinical Nurse Specialist (CNS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 4th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689753089 NPPES
Virginia MEDICAID 5510241
Virginia Other 239232

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