1972564086 NPI number — MRS. MAUREEN M BIGGS FNP LLC

Table of content: MRS. MAUREEN M BIGGS FNP LLC (NPI 1972564086)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972564086 NPI number — MRS. MAUREEN M BIGGS FNP LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIGGS
Provider First Name:
MAUREEN
Provider Middle Name:
M
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP LLC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BIGGS
Provider Other First Name:
MAUREEN
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1972564086
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
309 WALNUT ST
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
AMITE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70422
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-748-9812
Provider Business Mailing Address Fax Number:
985-748-9818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
309 WALNUT ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
AMITE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70422
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-748-9812
Provider Business Practice Location Address Fax Number:
985-748-9818
Provider Enumeration Date:
03/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  0499543092 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 0499543092 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1550477 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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