Provider Demographics
NPI:1235573213
Name:HIGGINS, TARA YVONNE (RN)
Entity Type:Individual
Prefix:MS
First Name:TARA
Middle Name:YVONNE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 OKOLONA DR
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650-1387
Mailing Address - Country:US
Mailing Address - Phone:423-743-9103
Mailing Address - Fax:423-743-9105
Practice Address - Street 1:101 OKOLONA DR
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-1387
Practice Address - Country:US
Practice Address - Phone:423-743-9103
Practice Address - Fax:423-743-9105
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000183715163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health