Healthcare Provider Details

I. General information

NPI: 1801283957
Provider Name (Legal Business Name): HEATHER JUNE BIGBY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2015
Last Update Date: 11/24/2024
Certification Date: 11/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 N MIDLAND AVE
NYACK NY
10960-1912
US

IV. Provider business mailing address

16 WASHINGTON MEWS
PORT CHESTER NY
10573-3916
US

V. Phone/Fax

Practice location:
  • Phone: 845-348-2660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number421044
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number417
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF001565
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM1426
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number417
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: