Provider Demographics
NPI:1285798413
Name:BIGGERSTAFF, GILLIAN M (DC)
Entity type:Individual
Prefix:DR
First Name:GILLIAN
Middle Name:M
Last Name:BIGGERSTAFF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-3021
Mailing Address - Country:US
Mailing Address - Phone:712-276-4946
Mailing Address - Fax:712-276-4599
Practice Address - Street 1:4701 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-3021
Practice Address - Country:US
Practice Address - Phone:712-276-4946
Practice Address - Fax:712-276-4599
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06766111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA251545OtherMIDLANDS CHOICE
IA08214OtherBLUE CROSS BLUE SHIELD
IA0484980Medicaid
IA0484980Medicaid
IA17502Medicare ID - Type Unspecified