Healthcare Provider Details

I. General information

NPI: 1023973377
Provider Name (Legal Business Name): KHIAMBER BIGELOW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 E DAVIS ST
BURLINGTON NC
27215-5922
US

IV. Provider business mailing address

2444 MAPLE AVE # 121
BURLINGTON NC
27215-7116
US

V. Phone/Fax

Practice location:
  • Phone: 336-513-8550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: