Provider Demographics
NPI:1154334852
Name:HIGGINS, GAYLE NYBERG (MSN CRNP)
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:NYBERG
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:MSN CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:NJ
Mailing Address - Zip Code:08065-1924
Mailing Address - Country:US
Mailing Address - Phone:215-427-3814
Mailing Address - Fax:215-427-4621
Practice Address - Street 1:FRONT STREET AND ERIE AVE
Practice Address - Street 2:ST.CHRISTOPHER'S HOSPITAL FOR CHILDREN
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134
Practice Address - Country:US
Practice Address - Phone:215-427-3814
Practice Address - Fax:215-427-4621
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007789363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics