MEDICARE: ELAINA HIGGINS NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	5027P	KY
2	363L00000X	Nurse Practitioner	12265	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427181015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINA HIGGINS NP

Provider Business Mailing Address
First Line	:	1820 HAYNES ST
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37043-4547
Country	:	US
Telephone Number	:	931-245-1500
Fax Number	:	931-245-1500

Provider Business Practice Location Address
First Line	:	1820 HAYNES ST
Second Line	:
City	:	CLARKSVILLE
State	:	TN
Zip	:	37043-4547
Country	:	US
Telephone Number	:	931-245-1500
Fax Number	:	931-245-1544

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	05/01/2014

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