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General NPI Number Information
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NPI Number | 1336553601
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Entity Type | Individual
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Provider Name | SUE ANN HIGINBOTHAM RN
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Gender | Female
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 06/16/2014
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Provider Practice Location Address
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Address Line | 13140 W EL LOBO RD
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City | TUCSON
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State | AZ
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Zip | 85743-9390
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Country | US
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Telephone | 608-395-9653
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Fax |
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Provider Business Mailing Address
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Address Line | 13140 W EL LOBO RD
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City | TUCSON
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State | AZ
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Zip | 85743-9390
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Country | US
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Telephone | 608-395-9653
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | TRN185728
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 174788-30
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License Number State | WI
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