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General NPI Number Information
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NPI Number | 1598636748
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Entity Type | Individual
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Provider Name | BROOKLYN DANIELLE HIGGINBOTHAM APRN, CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 740 S LIMESTONE STE K201
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City | LEXINGTON
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State | KY
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Zip | 40536-0001
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Country | US
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Telephone | 859-323-6211
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Fax | 859-257-0491
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Provider Business Mailing Address
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Address Line | 4709 BUD LN
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City | LEXINGTON
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State | KY
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Zip | 40514-1452
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Country | US
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Telephone | 859-230-4539
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 4044603
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 4044603
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License Number State | KY
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