MEDICARE: CARLA ADDISON HIGGINS RD

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	133V00000X	Registered Dietitian	DN003264	PA

General Provider Information

NPI Number	:	1548002355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLA ADDISON HIGGINS RD

Provider Business Mailing Address
First Line	:	7 DOCK HILL RD
Second Line	:
City	:	MIDDLEBURG
State	:	PA
Zip	:	17842-8910
Country	:	US
Telephone Number	:	570-837-2123
Fax Number	:	570-837-2185

Provider Business Practice Location Address
First Line	:	4150 WASHINGTON RD STE 211
Second Line	:
City	:	CANONSBURG
State	:	PA
Zip	:	15317-2534
Country	:	US
Telephone Number	:	412-746-7613
Fax Number	:

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

Provider Enumeration Date	:	06/11/2024
Last Update Date	:	03/16/2026

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Directions to “ CARLA ADDISON HIGGINS RD” Practice Location

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