Healthcare Provider Details

I. General information

NPI: 1679507180
Provider Name (Legal Business Name): JENIFER DONNELL HIGGINS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENIFER DONNELL KOWALIK MD

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 S PLUMMER AVE
CHANUTE KS
66720-1928
US

IV. Provider business mailing address

629 S PLUMMER AVE
CHANUTE KS
66720-1928
US

V. Phone/Fax

Practice location:
  • Phone: 620-431-0340
  • Fax: 620-431-0434
Mailing address:
  • Phone: 620-431-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number36180328
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK5514
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberK5514
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberK5514
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04-50769
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: