Healthcare Provider Details

I. General information

NPI: 1760546022
Provider Name (Legal Business Name): SANDRA M HIGGINS FNP,CS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANDRA M MORA FNP,CS

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 FIR ST ST CATHERINE HOSPITAL SUITE313
EAST CHICAGO IN
46312
US

IV. Provider business mailing address

5740 WILDROSE LN
SCHERERVILLE IN
46375-3508
US

V. Phone/Fax

Practice location:
  • Phone: 219-392-7424
  • Fax: 219-392-7450
Mailing address:
  • Phone: 219-793-9532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number71001298A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: