Provider Demographics
NPI:1417775586
Name:HIGGINS, KALI DAWN
Entity type:Individual
Prefix:
First Name:KALI
Middle Name:DAWN
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:
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 32561
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99803-2561
Mailing Address - Country:US
Mailing Address - Phone:907-921-1291
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 368
Practice Address - Street 2:
Practice Address - City:DELTA JUNCTION
Practice Address - State:AK
Practice Address - Zip Code:99737-0368
Practice Address - Country:US
Practice Address - Phone:541-602-8980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-28
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program