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LISA RENAE BIGELOW

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1700495207

Individual Registrant:
 LISA RENAE BIGELOW 
Gender: F
Sole Proprietor

Location and contact information for practice:
1024 SPANISH TRAIL, P132  EAGAR, AZ 85925-8592 US
Tel: 928-245-0012  Fax: --

Contact information for business:
606 N MAIN ST  EAGAR, AZ 85925-9813 US
Tel: 928-333-5333  Fax: --

Registration Information:
NPI: 1700495207
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
AZ242067

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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