Healthcare Provider Details

I. General information

NPI: 1316631237
Provider Name (Legal Business Name): DR. SARAH JANE BIGELOW NICOL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DRIVE NC MEMORIAL HOSPITAL, 2ND FLOOR
CHAPEL HILL NC
27514
US

IV. Provider business mailing address

101 MANNING DRIVE NC MEMORIAL HOSPITAL, 2ND FLOOR
CHAPEL HILL NC
27514
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-1315
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5018398
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5018398
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: