Provider Demographics
NPI:1790794204
Name:BIGELOW, SHARON M
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:M
Last Name:BIGELOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4411 BEN FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27702
Mailing Address - Country:US
Mailing Address - Phone:919-477-0047
Mailing Address - Fax:919-477-6919
Practice Address - Street 1:4411 BEN FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27702
Practice Address - Country:US
Practice Address - Phone:919-477-0047
Practice Address - Fax:919-477-6919
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC75710363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner