Individual
MRS. ANDREA S. HIGGINBOTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
13280 EVENING CREEK DR S STE 225, SAN DIEGO, CA 92128-4664
(877) 257-0637
Mailing address
13280 EVENING CREEK DR S STE 225, SAN DIEGO, CA 92128-4664
(205) 930-2456
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-105427
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011846
MEDICARE GROUP PAYEE NUMBER
AL
01
—
1063439065
NPI SITE GROUP PAYEE NUMBER
AL
05
—
630000013
—
AL
Enumeration date
09/25/2009
Last updated
11/01/2024
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