Healthcare Provider Details

I. General information

NPI: 1427265081
Provider Name (Legal Business Name): ELLEN M HIGGINS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1756 ROUTE 9D
COLD SPRING NY
10516-2619
US

IV. Provider business mailing address

50 DAYTON LN SUITE 202
PEEKSKILL NY
10566-2859
US

V. Phone/Fax

Practice location:
  • Phone: 845-809-5661
  • Fax: 845-809-5663
Mailing address:
  • Phone: 914-739-0087
  • Fax: 914-737-1714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF3334491
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: