Diane J Bigelow, LPN
Individual provider Active NPI Licensed Practical Nurse · Brockport, NY
NPI 1629417548 · NPPES record last updated Jun 25, 2013
Key facts
- NPI
- 1629417548
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 204041-1 (NY)
- Practice address
- 69 Spring St
Brockport, NY 14420-2045 - Phone
- (585) 637-7647
- NPI assigned
- Jun 25, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 204041-1 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 204041-1 | NY | Yes |
Addresses
Primary practice location
69 Spring St
Brockport, NY 14420-2045
Mailing address
69 Spring St
Brockport, NY 14420-2045
Phone (585) 637-7647
Other providers in Brockport, NY
- Nichole Elizabeth Bedford
- Darcy Louise Beeman
- Catherine M. Benjamin
- Scott F Berry
- Natalie Ada Bertoia
- Darlene Biondolillo
- Kaitlyn Bjelko
- Jordan Block
- Barbara S Blosenhauer
- Dana Bolton
All providers in Brockport, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.