MEDICARE: DIANE MARIE BIGELOW LMT; RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	20406	AK
2	225700000X	Massage Therapist	243479	AK

General Provider Information

NPI Number	:	1316277163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE MARIE BIGELOW LMT; RN

Provider Business Mailing Address
First Line	:	3823 SPENARD RD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99517-2678
Country	:	US
Telephone Number	:	907-677-1600
Fax Number	:	907-677-2779

Provider Business Practice Location Address
First Line	:	3823 SPENARD RD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99517-2678
Country	:	US
Telephone Number	:	907-677-1600
Fax Number	:	907-677-2779

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2009
Last Update Date	:	05/13/2026

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