Provider Demographics
NPI:1588385215
Name:BIGELOW, KATY (FNP-BC)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:
Last Name:BIGELOW
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 YOUNGS RD STE 203
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8024
Mailing Address - Country:US
Mailing Address - Phone:716-636-9004
Mailing Address - Fax:
Practice Address - Street 1:1150 YOUNGS RD STE 203
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8024
Practice Address - Country:US
Practice Address - Phone:716-636-9004
Practice Address - Fax:716-636-0132
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349886207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine