Individual
MISS MELISSA MARIE HIGGENBOTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2400 CATON FARM RD, K, CREST HILL, IL 60403-1386
(815) 609-9081
Mailing address
2400 CATON FARM RD, K, CREST HILL, IL 60403-1386
(815) 609-9081
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043-081332
IL
Other
Enumeration date
06/18/2009
Last updated
06/18/2009
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