Healthcare Provider Details

I. General information

NPI: 1437803301
Provider Name (Legal Business Name): JAMIE L HIGGINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 W 29TH ST
SAND SPRINGS OK
74063-5016
US

IV. Provider business mailing address

709 W 29TH ST
SAND SPRINGS OK
74063-5016
US

V. Phone/Fax

Practice location:
  • Phone: 918-729-2770
  • Fax:
Mailing address:
  • Phone: 918-729-2770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number9672A
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number9672A
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code246Q00000X
TaxonomyPathology Specialist/Technologist
License Number9672A
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number9672A
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: