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NPI Code Detail

MEDICARE: VALERIE HIGGINBOTHAM WHNP-BC

MEDICARE: VALERIE HIGGINBOTHAM WHNP-BC
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
1364SW0102XWomen's Health Clinical Nurse Specialist120591MO

Other Identifiers

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

General Provider Information

NPI Number : 1790873743
Entity Type Code : Individual
Provider Name (Legal Business Name) : VALERIE HIGGINBOTHAM WHNP-BC
Provider Business Mailing Address
First Line : 3704 MORAD CT
Second Line :
City : FLORISSANT
State : MO
Zip : 63034-1529
Country : US
Telephone Number : 314-340-3261
Fax Number : 314-814-8542
Provider Business Practice Location Address
First Line : 4414 N FLORISSANT AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63107-1812
Country : US
Telephone Number : 314-814-8515
Fax Number : 314-814-8542
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 03/27/2013

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Directions to “ VALERIE HIGGINBOTHAM WHNP-BC” Practice Location

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