Doctor Name: | MS. MIRIAM HIGGINBOTHAM |
NPI Number: | 1124082284 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | C-FNP |
License Number: | 0382302-22 (FNP) |
Business Practice Address: | 1143 Dunbar Ave Dunbar, WV - 250643121 |
Business Phone Number: | 3047688523 |
Business Fax Number: | 3047688627 |
Mailing Address: | 415 Morris St Ste 304, CHARLESTON |
State: | WV |
Postal Code: | 253011853 |
Phone Number: | 3043887783 |
Fax Number: | 3043887788 |
NPI Enumeration Date: | 04/14/2006 |
NPI Last Update Date: | 01/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 0382302-22 (FNP) |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |