Healthcare Provider Details

I. General information

NPI: 1376955856
Provider Name (Legal Business Name): JACQUELINE CHRISTINE HIGGINBOTTOM ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACQUELINE CHRISTINE ROSS RN

II. Dates (important events)

Enumeration Date: 06/02/2014
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TAMPA GENERAL CIR PALLIATIVE CARE OFFICE
TAMPA FL
33606-3571
US

IV. Provider business mailing address

PO BOX 917770
ORLANDO FL
32891-0001
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-7000
  • Fax: 813-844-1609
Mailing address:
  • Phone: 813-974-2201
  • Fax: 813-974-4325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9308803
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1014133
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9308803
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: