Individual
MITRA HERAVI-HIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103
(336) 768-3212
(336) 768-9019
Mailing address
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103-6983
(336) 768-3212
(336) 768-9019
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
041502
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
1405
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050704
—
NC
Enumeration date
06/11/2006
Last updated
05/04/2026
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