Provider Demographics
NPI:1669804563
Name:BIGGANE, JILL (RN)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:BIGGANE
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 1:2000 TRIDENT WAY
Mailing Address - Street 2:BLDG 600 LOGSU
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92155-5599
Mailing Address - Country:US
Mailing Address - Phone:619-537-3281
Mailing Address - Fax:619-437-5614
Practice Address - Street 1:2000 TRIDENT WAY
Practice Address - Street 2:BLDG 600 LOGSU
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92155-5599
Practice Address - Country:US
Practice Address - Phone:619-537-3281
Practice Address - Fax:619-437-5614
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY406767-1163W00000X
MARN2264937163W00000X
GARN168760163W00000X
CA744682163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse