Individual
NICOLETTE LAUREN BIGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4500 MEMORIAL DR, BELLEVILLE, IL 62226-5360
(618) 233-7750
Mailing address
1107 MISSISSIPPI AVE, APARTMENT 504, SAINT LOUIS, MO 63104-2458
(618) 698-1546
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004820
IL
Other
Enumeration date
09/20/2013
Last updated
04/20/2018
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