Provider Demographics
NPI:1760546022
Name:HIGGINS, SANDRA M (FNP,CS)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:M
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:FNP,CS
Other - Prefix:MRS
Other - First Name:SANDRA
Other - Middle Name:M
Other - Last Name:MORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP,CS
Mailing Address - Street 1:5740 WILDROSE LN
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-3508
Mailing Address - Country:US
Mailing Address - Phone:219-793-9532
Mailing Address - Fax:
Practice Address - Street 1:4321 FIR ST ST CATHERINE HOSPITAL
Practice Address - Street 2:SUITE313
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312
Practice Address - Country:US
Practice Address - Phone:219-392-7424
Practice Address - Fax:219-392-7450
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001298A363LX0106X
IL363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily