Evan Patrick Bickerstaff, is a
Student In An Organized Health Care Education/training Program based in Kokomo, Indiana. Evan Patrick Bickerstaff is licensed to practice in * (Not Available) (license number ) and his current practice location is
1907 W Sycamore St, Kokomo, Indiana. He can be reached at his office (for appointments etc.) via phone at
(765) 452-5611.
NPI number for Evan Patrick Bickerstaff is 1790588150 and his current mailing address is 5816 Beacon Cove Way, Indianapolis, Indiana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1790588150.
Provider's Profile
| Full Name | Evan Patrick Bickerstaff |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1907 W Sycamore St, Kokomo, Indiana |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1790588150
- Provider Enumeration Date: 03/31/2025
- Last Update Date: 05/07/2025
Medical Identifiers
Medical identifiers for Evan Patrick Bickerstaff such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790588150 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 28254369A (Indiana) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Evan Patrick Bickerstaff is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Evan Patrick Bickerstaff,
5816 Beacon Cove Way,
Indianapolis, IN 46237-9192
Ph: (270) 933-2552 | Evan Patrick Bickerstaff,
1907 W Sycamore St,
Kokomo, IN 46901-5148
Ph: (765) 452-5611 |
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