Provider Demographics
NPI:1508913237
Name:BIGGS, MARY SUZANNE RYAN (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:MARY SUZANNE
Middle Name:RYAN
Last Name:BIGGS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:SUZANNE
Other - Middle Name:RYAN
Other - Last Name:BIGGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNPC
Mailing Address - Street 1:189 BILL LN
Mailing Address - Street 2:
Mailing Address - City:BEAN STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37708-4049
Mailing Address - Country:US
Mailing Address - Phone:727-244-0916
Mailing Address - Fax:630-381-4094
Practice Address - Street 1:121 N CONCORD ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-2330
Practice Address - Country:US
Practice Address - Phone:865-673-6741
Practice Address - Fax:865-673-6634
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN3404062363LF0000X
FLARNP3404062363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ012493Medicaid