Provider Demographics
NPI:1265739635
Name:BIGGS, JENNIFER E (PA-C)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:E
Last Name:BIGGS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 SHIPYARD BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-6431
Mailing Address - Country:US
Mailing Address - Phone:910-399-3755
Mailing Address - Fax:910-202-9966
Practice Address - Street 1:613 SHIPYARD BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6492
Practice Address - Country:US
Practice Address - Phone:910-833-0075
Practice Address - Fax:910-202-9966
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-22
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09747363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPA60157471OtherMEDICAL LICENSE