Individual
LISA RENAE BIGELOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1024 SPANISH TRAIL, P132, EAGAR, AZ 85925-8592
(928) 245-0012
Mailing address
606 N MAIN ST, EAGAR, AZ 85925-9813
(928) 333-5333
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
242067
AZ
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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