Provider Demographics
NPI:1225463359
Name:BIGFORD, MONICA BLAKE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:BLAKE
Last Name:BIGFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 OLD FURNACE RD
Mailing Address - Street 2:
Mailing Address - City:CHESNEE
Mailing Address - State:SC
Mailing Address - Zip Code:29323-9639
Mailing Address - Country:US
Mailing Address - Phone:864-578-0128
Mailing Address - Fax:
Practice Address - Street 1:3231 OLD FURNACE RD
Practice Address - Street 2:
Practice Address - City:CHESNEE
Practice Address - State:SC
Practice Address - Zip Code:29323-9639
Practice Address - Country:US
Practice Address - Phone:864-578-0128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC90921163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse