MEDICARE: HAVEN MARIE HIGGINS

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	225100000X	Physical Therapist	P24971	NC

General Provider Information

NPI Number	:	1699603316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAVEN MARIE HIGGINS

Provider Business Mailing Address
First Line	:	5710 OLEANDER DR STE 211
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-4722
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5710 OLEANDER DR STE 211
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-4722
Country	:	US
Telephone Number	:	910-398-6301
Fax Number	:

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

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/26/2026

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