Provider Demographics
NPI:1194890004
Name:HIGDON, ELIZABETH B (FNP-BC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:B
Last Name:HIGDON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 ADAMS LN
Mailing Address - Street 2:SUITE 13
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3598
Mailing Address - Country:US
Mailing Address - Phone:615-288-4087
Mailing Address - Fax:615-739-5919
Practice Address - Street 1:151 ADAMS LN
Practice Address - Street 2:SUITE 13
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3598
Practice Address - Country:US
Practice Address - Phone:615-288-4087
Practice Address - Fax:615-553-4250
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12327363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3370172Medicare PIN
TN1194890004Medicare PIN