MEDICARE: DANIEL HIGDON

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	822075	NV

General Provider Information

NPI Number	:	1336025642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL HIGDON

Provider Business Mailing Address
First Line	:	8878 SASQUATCH RUN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89166-6720
Country	:	US
Telephone Number	:	315-783-5643
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 S VALLE VERDE DR STE 265
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-3434
Country	:	US
Telephone Number	:	315-783-5643
Fax Number	:

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

Provider Enumeration Date	:	08/12/2025
Last Update Date	:	08/12/2025

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Directions to “ DANIEL HIGDON ” Practice Location

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