Healthcare Provider Details

I. General information

NPI: 1407852163
Provider Name (Legal Business Name): JOANNE MARIE HIGGINS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 MANOR DR
CHALFONT PA
18914-2282
US

IV. Provider business mailing address

610 W GERMANTOWN PIKE STE 150
PLYMOUTH MEETING PA
19462-1062
US

V. Phone/Fax

Practice location:
  • Phone: 116-326-7954
  • Fax:
Mailing address:
  • Phone: 610-525-4966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN273344L
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN273344L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: