Provider Demographics
NPI:1003145467
Name:BIGHAM, BETH ANN (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:BIGHAM
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9318 STATE ROUTE 14
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241
Mailing Address - Country:US
Mailing Address - Phone:330-626-3455
Mailing Address - Fax:330-626-4189
Practice Address - Street 1:2883 MIDDLETON RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-1907
Practice Address - Country:US
Practice Address - Phone:864-905-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN266651163W00000X
OH13075-NP363LF0000X
SC1156363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCMB2049458OtherFED DEA