Provider Demographics
NPI:1710203328
Name:HIGGINS, JESSE M (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:JESSE
Middle Name:M
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:JESSE
Other - Middle Name:M
Other - Last Name:SLUTSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 422
Mailing Address - Street 2:ACADIA HOSPITAL CORP.
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04402-0422
Mailing Address - Country:US
Mailing Address - Phone:207-973-6100
Mailing Address - Fax:207-973-6109
Practice Address - Street 1:302 HUSSON AVE
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3374
Practice Address - Country:US
Practice Address - Phone:207-941-2373
Practice Address - Fax:207-941-8803
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP101016363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1710203328Medicaid