Healthcare Provider Details

I. General information

NPI: 1487632287
Provider Name (Legal Business Name): DAWN M HIGGINS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 W RIDGEWAY AVE
WATERLOO IA
50701-4543
US

IV. Provider business mailing address

1717 W RIDGEWAY AVE
WATERLOO IA
50701-4543
US

V. Phone/Fax

Practice location:
  • Phone: 319-833-5700
  • Fax: 319-833-5740
Mailing address:
  • Phone: 319-833-5700
  • Fax: 319-833-5740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number087431
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: