Provider Demographics
NPI:1215732128
Name:BIGELOW, CHRISTINA L
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:BIGELOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 HOLYROOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-3801
Mailing Address - Country:US
Mailing Address - Phone:774-289-2610
Mailing Address - Fax:
Practice Address - Street 1:51 HOLYROOD AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-3801
Practice Address - Country:US
Practice Address - Phone:774-289-2610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2024065948363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health