MEDICARE: MRS. BRENDA KAY HIGGINS NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	R840052	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285988154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRENDA KAY HIGGINS NP-C

Provider Business Mailing Address
First Line	:	703 16TH AVE S
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39701-6927
Country	:	US
Telephone Number	:	662-574-1439
Fax Number	:

Provider Business Practice Location Address
First Line	:	1503 HIGHWAY 45 N
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-2113
Country	:	US
Telephone Number	:	662-328-9623
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2012
Last Update Date	:	12/20/2013

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