Provider Demographics
NPI:1255002606
Name:HIGGINS, JILL K
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:K
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 THE PLAINS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20117-2691
Mailing Address - Country:US
Mailing Address - Phone:540-326-4536
Mailing Address - Fax:
Practice Address - Street 1:119 THE PLAINS RD STE 300
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:VA
Practice Address - Zip Code:20117-2691
Practice Address - Country:US
Practice Address - Phone:540-326-4536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024182723363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health