Provider Demographics
NPI:1629838776
Name:HIGGINS, ANNETTE SHEADRICK
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:SHEADRICK
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 1:58775 CHENNAULT DR
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48048-2705
Mailing Address - Country:US
Mailing Address - Phone:586-749-9775
Mailing Address - Fax:
Practice Address - Street 1:58451 STEVENS ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:MI
Practice Address - Zip Code:48048-2761
Practice Address - Country:US
Practice Address - Phone:810-459-2955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant