Provider Demographics
NPI:1093064164
Name:HIGGINS, MARY F (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:F
Last Name:HIGGINS
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Gender:F
Credentials:FNP-BC
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Mailing Address - Street 1:36 ESSEX RD
Mailing Address - Street 2:LAHEY IPSWICH
Mailing Address - City:IPSWICH
Mailing Address - State:MA
Mailing Address - Zip Code:01938-2599
Mailing Address - Country:US
Mailing Address - Phone:978-356-5522
Mailing Address - Fax:978-356-0218
Practice Address - Street 1:36 ESSEX RD
Practice Address - Street 2:LAHEY IPSWICH
Practice Address - City:IPSWICH
Practice Address - State:MA
Practice Address - Zip Code:01938-2599
Practice Address - Country:US
Practice Address - Phone:978-356-5522
Practice Address - Fax:978-356-0218
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2013-08-16
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Provider Licenses
StateLicense IDTaxonomies
MARN280911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110095175AMedicaid
MA002989902Medicare PIN