Healthcare Provider Details

I. General information

NPI: 1124076906
Provider Name (Legal Business Name): WENDY MICHELLE HIGGINS RN, APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 09/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10412 ALLISONVILLE ROAD SUITE #100
FISHERS IN
46038
US

IV. Provider business mailing address

10412 ALLISONVILLE ROAD SUITE #100
FISHERS IN
46038
US

V. Phone/Fax

Practice location:
  • Phone: 317-572-2240
  • Fax:
Mailing address:
  • Phone: 317-572-2240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number28221329A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: