Healthcare Provider Details

I. General information

NPI: 1700541273
Provider Name (Legal Business Name): PAMELA ANN BIGLOW-HEARST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 11/01/2021
Certification Date: 10/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CORNER OF ROUTE N12 & N7
FORT DEFIANCE AZ
86504
US

IV. Provider business mailing address

3066 ZELDA RD # 319
MONTGOMERY AL
36106-2651
US

V. Phone/Fax

Practice location:
  • Phone: 928-729-8000
  • Fax:
Mailing address:
  • Phone: 714-684-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number4676
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: