=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467221713
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CRYSTAL RENEE HIGGINS RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/28/2023
-----------------------------------------------------
Last Update Date | 03/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 NORTHVIEW PLZ
-----------------------------------------------------
City | NORTH WILKESBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28659-3173
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-818-5068
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 223 WASHINGTON AVE
-----------------------------------------------------
City | NORTH WILKESBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28659-7769
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-957-1397
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
-----------------------------------------------------
License Number | 355191
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------