Provider Demographics
NPI:1497361893
Name:HIGUERA, LOUISE (NP)
Entity Type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:
Last Name:HIGUERA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1064 OAKHALL DR
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-6341
Mailing Address - Country:US
Mailing Address - Phone:850-339-3466
Mailing Address - Fax:
Practice Address - Street 1:1600 WESTGATE CIR STE 125
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8068
Practice Address - Country:US
Practice Address - Phone:615-591-1965
Practice Address - Fax:629-202-4919
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28138363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner