Higginbotham, Dale

Higginbotham, Dale is an sole proprietor health care provider with primary practice located at 1523 22Nd Ave Suite B, Meridian MS 39301-4016. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Higginbotham, Dale can be contacted via phone (601) 703-8370.

Contact Information

Primary practice address
1523 22Nd Ave Suite B Meridian MS 39301-4016
Phone: (601) 703-8370
Fax: (855) 320-7336
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1101944 Alabama
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R668885 Mississippi

Profile Details

NPI number 1093798894
LBN Legal business name Higginbotham, Dale
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 25th, 2005
Last updated Dec 30th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093798894 NPPES
Mississippi MEDICAID 06172593

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