person
Maxine Kidder, PNP
Pediatric Nurse Practitioner in Lockport, New York
NPI 1124084090

Maxine Kidder is a Pediatric Nurse Practitioner based in Lockport, NY and is specialized in Pediatrics. Maxine Kidder practices in Lockport, NY and has the professional credentials of PNP. The NPI Number for Maxine Kidder is 1124084090 and holds a License No. 380525 (New York).

The current practice location address for Maxine Kidder is 139 Professional Pkwy, Lockport, NY and can be reached out via phone at 716-433-6711 and via fax at 716-433-0546.

Location: 139 Professional Pkwy, Lockport, NY, 14094-5369
person
Provider Profile Details
NPI Number
1124084090
Provider Name
Maxine Kidder
Credential
PNP
Provider Entity Type
Individual
Gender
Female
Address
139 Professional Pkwy, Lockport, NY, 14094-5369
Phone Number
716-433-6711
Fax Number
716-433-0546
Provider Enumeration Date
04/21/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000560073003 01 NY BLUE CROSS/BLUE SHIELD
9512424 01 NY INDEPENDENT HEALTH
01400724 05 NY
institution
Provider Business Practice Location Address Details
Address
139 Professional Pkwy
City
State
Zip
14094-5369
Phone Number
716-433-6711
Fax Number
716-433-0546
person
Provider Business Mailing Address Details
Address
139 Professional Pkwy
City
State
Zip
14094-5369
Phone Number
716-433-6711
Fax Number
716-433-0546
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
380525 (New York)
Definition
Definition to come...
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