Provider Demographics
NPI:1629666318
Name:HIGGS, DOLLY TATENDA (FNP)
Entity Type:Individual
Prefix:
First Name:DOLLY
Middle Name:TATENDA
Last Name:HIGGS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DOLLY
Other - Middle Name:
Other - Last Name:MUZIRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:811 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-3558
Mailing Address - Country:US
Mailing Address - Phone:320-631-7200
Mailing Address - Fax:320-631-0534
Practice Address - Street 1:811 2ND ST SE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3558
Practice Address - Country:US
Practice Address - Phone:320-631-7200
Practice Address - Fax:320-632-0534
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily