Individual
TARA HIGGINBOTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
23699 QUAIL LANE, MANDEVILLE, LA 70448
(985) 334-4040
Mailing address
23699 QUAIL LANE, MANDEVILLE, LA 70448
(985) 334-4040
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
227420
LA
Other
Enumeration date
03/15/2018
Last updated
01/25/2023
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