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Individual

SHANE M HIGGINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
640 S 19TH ST STE 100, NEVADA, IA 50201
(515) 382-5413
(515) 382-7107
Mailing address
640 S 19TH ST STE 100, NEVADA, IA 50201-2902
(515) 382-5413
(515) 382-7107

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001492
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DA1548
RR MEDICARE GROUP
01
P00709212
RR MEDICARE
Enumeration date
12/13/2005
Last updated
05/07/2026
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