Provider Demographics
NPI:1063050631
Name:HIGGINS, SHIRLEY (FNP-C)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 834
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77879-0834
Mailing Address - Country:US
Mailing Address - Phone:832-353-4108
Mailing Address - Fax:
Practice Address - Street 1:550 WESTCOTT ST STE 520
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-9001
Practice Address - Country:US
Practice Address - Phone:713-864-6694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2019-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143359363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily