| Doctor Name: | MISTY D BICIOCCHI |
| NPI Number: | 1013214576 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | 209008627 |
| Business Practice Address: | 2615 Edwards St Suite 171 Alton, IL - 620023915 |
| Business Phone Number: | 6184624342 |
| Business Fax Number: | 6184625334 |
| Mailing Address: | 2615 Edwards St, Suite 171 ALTON |
| State: | IL |
| Postal Code: | 620023915 |
| Phone Number: | 6184624342 |
| Fax Number: | 6184625334 |
| NPI Enumeration Date: | 02/18/2011 |
| NPI Last Update Date: | 08/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209008627 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |