Healthcare Provider Details

I. General information

NPI: 1245848548
Provider Name (Legal Business Name): ALEXANDRIA HIGGINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2020
Last Update Date: 12/08/2024
Certification Date: 12/08/2024
Deactivation Date: 08/01/2023
Reactivation Date: 11/21/2023

III. Provider practice location address

8100 WASHINGTON LN
WYNCOTE PA
19095-1600
US

IV. Provider business mailing address

1 MEDICAL PARK
WHEELING WV
26003-6379
US

V. Phone/Fax

Practice location:
  • Phone: 929-491-7700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: