Healthcare Provider Details

I. General information

NPI: 1003547944
Provider Name (Legal Business Name): SHELBY LYNN HIGGINS DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHELBY LYNN WHALEY

II. Dates (important events)

Enumeration Date: 06/21/2022
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 NEEDHAM ST STE 300
NEWTON MA
02464-1502
US

IV. Provider business mailing address

38 SPRAGUE ST
HYDE PARK MA
02136-2570
US

V. Phone/Fax

Practice location:
  • Phone: 617-830-4522
  • Fax:
Mailing address:
  • Phone: 618-670-1592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN10034030
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: