LIA MICHELE WICKERHAM
Nurse Practitioner (Pediatrics)

Address: 300 Longwood Ave, Boston, MA 02115-5724

LIA MICHELE WICKERHAM (NPI# 1902499411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902499411
Entity Type Individual
Full Name LIA MICHELE WICKERHAM
Gender Female
Practice Address 300 Longwood Ave
Boston
MA 02115-5724
Practice Telephone 6173556000
Mailing Address 300 Longwood Ave
Boston
MA 02115-5724
Mailing Telephone 6173556000
Certification Date 2021-02-16
Enumeration Date 2021-02-16
Last Update Date 2021-02-16
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification Group License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
2306126 MA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 300 LONGWOOD AVE
City BOSTON
State MA
Zip Code 02115-5724

Providers in the same location

NPI Name Taxonomy Address Enumeration
1063006518 Lindsey Barlow Nurse Practitioner · Pediatrics 300 Longwood Ave, Boston, MA 02115-5724 2021-02-25
1114511748 Annemarie Kerry Nurse Practitioner · Neonatal, Critical Care 300 Longwood Ave, Boston, MA 02115-5724 2021-02-24
1215520184 Sophie Foss Clinical Neuropsychologist 300 Longwood Ave, Boston, MA 02115-5724 2021-02-11
1144812710 Allison Ryann Mcguinness Occupational Therapist 300 Longwood Ave, Boston, MA 02115-5724 2021-02-05
1891384707 Shawn Hamilton Kelly Pediatrics 300 Longwood Ave, Boston, MA 02115-5724 2021-01-14
1871182055 Kathleen Elizabeth Mavrogiannis · Kathleen Elizabeth Joumas Nurse Practitioner · Pediatrics 300 Longwood Ave, Boston, MA 02115-5724 2021-01-13
1629665302 Abdulrahman Aldeeri Medical Genetics · Clinical Genetics (M.D.) 300 Longwood Ave, Boston, MA 02115-5724 2020-12-28
1558967463 Jeffrey Pierre-Paul Pharmacist 300 Longwood Ave, Boston, MA 02115-5724 2020-12-07
1053916254 Francesca Sperotto Pediatrics · Pediatric Cardiology 300 Longwood Ave, Boston, MA 02115-5724 2020-12-03
1124623988 Lauren Kracoff Occupational Therapist 300 Longwood Ave, Boston, MA 02115-5724 2020-12-01
Find all providers in the same address

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1487159851 Gareth Marshall Student in an Organized Health Care Education/Training Program Boston Children's Hospital 300 Longwood Ave, Boston, MA 02115-5724 2018-03-28
1164832606 Olga I. Perez Social Worker · Clinical 328 Commonwealth Avenue, Apartment 1, Boston, MA 02115-5724 2014-05-06
1578823043 Dan Loberman Surgery · Vascular Surgery 27 Park Street, Hyannis, MA 02115-5724 2012-05-18
1922268424 Eric N Feins Thoracic Surgery (Cardiothoracic Vascular Surgery) Boston Children's Hospital -- 300 Longwood Avenue, Bader, 2nd Floor, Boston, MA 02115-5724 2008-06-10
1154535318 Carolyn A Stickney Internal Medicine 333 Longwood Ave, Lo 011, Critical Care Medicine, Boston Children's Hospital, Boston, MA 02115-5724 2007-05-09
1104961606 Boston Brace International Inc. · Nopco Prosthetic/Orthotic Supplier 319 Longwood Ave, Suite 102, Boston, MA 02115-5724 2007-02-21
1396776159 David A Kane Pediatrics Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115-5724 2006-07-06

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1316532187 Mary Louise Gargan Student in an Organized Health Care Education/Training Program 75 Francis Street Brigham and Women's Hospital. Abdomin, Boston, MA 02115 2021-03-04
1720678592 Abdulrhman Aleisa Student in an Organized Health Care Education/Training Program 75 Francis Street, Boston, MA 02115 2021-01-25
1659961662 Shixiao He Student in an Organized Health Care Education/Training Program 75 Francis Street, Suite Bc-3-010, Boston, MA 02115 2021-01-23
1760083067 Tracy Ng Social Worker · Clinical 75 Francis Street, Care Continuum Management, Boston, MA 02115 2020-11-03
1275132078 Olivia Wilkins Student in an Organized Health Care Education/Training Program 360 Huntington Ave, 202 Robinson Hall Physician Assistant Program, Boston, MA 02115 2020-10-22
1386241727 Vishal Ruparelia Student in an Organized Health Care Education/Training Program 336 Huntington Avenue, Boston, MA 02115 2020-10-08
1043817620 Kelly Cornelison Student in an Organized Health Care Education/Training Program 336 Huntington Ave, Boston, MA 02115 2020-10-06
1053918714 Meghan Patricia Ahearn Student in an Organized Health Care Education/Training Program 360 Huntington Avenue, 202 Robinson Hall, Boston, MA 02115 2020-10-06
1073110011 Crystal Rodriguez Student in an Organized Health Care Education/Training Program 360 Huntington Avenue, 202 Robinson Hall, Boston, MA 02115 2020-10-02
1013524339 Jacqueline Busa Student in an Organized Health Care Education/Training Program Northeastern University 336 Huntington Ave, Boston, MA 02115 2020-09-30
Find all providers in zip 02115

Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063006518 Lindsey Barlow 300 Longwood Ave, Boston, MA 02115-5724 2021-02-25
1871182055 Kathleen Elizabeth Mavrogiannis · Kathleen Elizabeth Joumas 300 Longwood Ave, Boston, MA 02115-5724 2021-01-13
1356945463 Tayler Marie O'Donnell 330 Brookline Ave, Boston, MA 02215-5491 2020-11-30
1356948525 Kaylee Woods 85 Seaport Blvd Unit 714, Boston, MA 02210-2157 2020-10-01
1558976845 Hilary Segar Garber · Hilary Caroline Segar 300 Longwood Ave, Boston, MA 02115-5724 2020-09-13
1184233470 Jayme Elizabeth Kelly 300 Longwood Ave, Boston, MA 02115-5724 2020-07-23
1144838384 Amanda Rose Bakos 218 Marion St, Boston, MA 02128-1758 2020-07-14
1396368460 Lauren Sell 300 Longwood Ave, Boston, MA 02115-5724 2020-05-25
1083236749 Mubina M Rhee 300 Longwood Ave, Boston, MA 02115-5724 2020-05-15
1033738307 Angelli Aguilar 300 Longwood Ave, Boston, MA 02115-5724 2020-04-15
Find all providers in BOSTON

Competitor

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City BOSTON
Zip Code 02115

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.