Healthcare Provider Details

I. General information

NPI: 1881913101
Provider Name (Legal Business Name): BARBARA L. HIGGINS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2010
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 NW BEAVER ST STE 100
PRINEVILLE OR
97754-1802
US

IV. Provider business mailing address

375 NW BEAVER ST STE 100
PRINEVILLE OR
97754-1802
US

V. Phone/Fax

Practice location:
  • Phone: 541-447-5165
  • Fax: 541-447-3093
Mailing address:
  • Phone: 541-447-5165
  • Fax: 541-447-3093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number000026106
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: