Provider Demographics
NPI:1992322069
Name:BIGNESS, REBECCA JO
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:JO
Last Name:BIGNESS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:JO
Other - Last Name:BIGNESS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSN, FNP
Mailing Address - Street 1:33 E SCHUYLER ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-1161
Mailing Address - Country:US
Mailing Address - Phone:315-343-6974
Mailing Address - Fax:315-342-3625
Practice Address - Street 1:33 E SCHUYLER ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-1161
Practice Address - Country:US
Practice Address - Phone:315-414-1358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-06
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF348265363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner