Healthcare Provider Details

I. General information

NPI: 1790794204
Provider Name (Legal Business Name): SHARON M BIGELOW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 BEN FRANKLIN RD
DURHAM NC
27702
US

IV. Provider business mailing address

4411 BEN FRANKLIN RD
DURHAM NC
27702
US

V. Phone/Fax

Practice location:
  • Phone: 919-477-0047
  • Fax: 919-477-6919
Mailing address:
  • Phone: 919-477-0047
  • Fax: 919-477-6919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number75710
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: