Healthcare Provider Details

I. General information

NPI: 1982336814
Provider Name (Legal Business Name): JESSICA BIGGS AGACNP-BC, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 POPLAR AVE
MEMPHIS TN
38157-0101
US

IV. Provider business mailing address

5050 POPLAR AVE
MEMPHIS TN
38157-0101
US

V. Phone/Fax

Practice location:
  • Phone: 901-276-2662
  • Fax:
Mailing address:
  • Phone: 901-276-2662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number208852
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number31970
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: