Healthcare Provider Details

I. General information

NPI: 1104082155
Provider Name (Legal Business Name): CARRIE DORSEY-HIGDON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 08/29/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE STE A-550
SAN FRANCISCO CA
94143
US

IV. Provider business mailing address

400 PARNASSUS AVE STE A-550
SAN FRANCISCO CA
94143-2202
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2350
  • Fax: 415-353-2337
Mailing address:
  • Phone: 415-353-2350
  • Fax: 415-353-2337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number531129
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9042
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: