Provider Demographics
NPI:1285741215
Name:HIGGINS, BARBARA R (CFNP)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:R
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:CFNP
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 1810
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39502-1810
Mailing Address - Country:US
Mailing Address - Phone:228-255-4300
Mailing Address - Fax:228-255-3626
Practice Address - Street 1:4300 LEISURE TIME DR
Practice Address - Street 2:
Practice Address - City:DIAMONDHEAD
Practice Address - State:MS
Practice Address - Zip Code:39525-3241
Practice Address - Country:US
Practice Address - Phone:228-255-4300
Practice Address - Fax:228-255-3626
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR619981363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00120116Medicaid
500000972Medicare ID - Type Unspecified
MS00120116Medicaid
S64085Medicare UPIN