Provider Demographics
NPI:1376538330
Name:HIGGINS, LEAH (PA-C)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 MIDDLEFORD RD
Mailing Address - Street 2:STE 502
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-3664
Mailing Address - Country:US
Mailing Address - Phone:302-628-8300
Mailing Address - Fax:302-628-8400
Practice Address - Street 1:1350 MIDDLEFORD RD
Practice Address - Street 2:STE 502
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3664
Practice Address - Country:US
Practice Address - Phone:302-628-8300
Practice Address - Fax:302-628-8400
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0000692363AM0700X
MDC0004279363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA057916OtherBLUE CARE
PA50076565OtherCAPITAL BLUE CROSS
PA970023109OtherRAILROAD MEDICARE
PA057916J67Medicare PIN
PA50076565OtherCAPITAL BLUE CROSS