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:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093798894 | NPPES |
| Mississippi | MEDICAID | 06172593 |
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