Provider Demographics
NPI:1215274451
Name:HIGGINS, NICOLE CHRISTINA (PA-C)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:CHRISTINA
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 SAINT HELENA ST
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENA
Mailing Address - State:NE
Mailing Address - Zip Code:68774-5036
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33 3RD ST SE STE 201
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-2064
Practice Address - Country:US
Practice Address - Phone:605-677-6274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1760363AM0700X
SD0845363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical