Provider Demographics
NPI:1407613631
Name:HIGGINS, KEATON L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KEATON
Middle Name:L
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 LEBANON PIKE CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-3216
Mailing Address - Country:US
Mailing Address - Phone:615-256-3023
Mailing Address - Fax:
Practice Address - Street 1:1732 LEBANON PIKE CIR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-3216
Practice Address - Country:US
Practice Address - Phone:615-256-3023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN473637183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist