Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 82514 | NE |
NPI | 1003567181 |
---|---|
Provider Name | Courtney Higgins |
First Address | Omaha, NE 68142-2168 |
Second Address | Omaha, NE 68130-4664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2022 |
Last Update Date | 11/01/2022 |