MEDICARE: MRS. DEBORAH LYNN HIGGINS

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	253J00000X	Foster Care Agency	1088288	MN

General Provider Information

NPI Number	:	1609391374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH LYNN HIGGINS

Provider Business Mailing Address
First Line	:	8288 REVELWOOD PL
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311-1534
Country	:	US
Telephone Number	:	612-801-2500
Fax Number	:

Provider Business Practice Location Address
First Line	:	8288 REVELWOOD PLACE
Second Line	:
City	:	MAPLE GROVE
State	:	MN
Zip	:	55311
Country	:	US
Telephone Number	:	612-801-2500
Fax Number	:

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

Provider Enumeration Date	:	08/03/2017
Last Update Date	:	07/21/2022

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