Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 13461 | AR |
NPI | 1245863547 |
---|---|
Provider Name | Mrs. Sheranda Hines-Higgins |
First Address | North Little Rock, AR 72118-3791 |
Second Address | North Little Rock, AR 72118-3791 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2020 |
Last Update Date | 15/02/2020 |