Healthcare Provider Details

I. General information

NPI: 1023052305
Provider Name (Legal Business Name): ROBERTA B HIGGINS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 EASTERN BYP STE 5
RICHMOND KY
40475-2406
US

IV. Provider business mailing address

795 EASTERN BYP STE 5
RICHMOND KY
40475-2406
US

V. Phone/Fax

Practice location:
  • Phone: 859-624-2229
  • Fax: 859-625-9458
Mailing address:
  • Phone: 859-624-2229
  • Fax: 859-625-9458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number2084M
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN.303543
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number3002084
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: