Provider Demographics
NPI:1790359685
Name:HIGUERA, JONI LYNN (NP)
Entity Type:Individual
Prefix:MRS
First Name:JONI
Middle Name:LYNN
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 1:6912 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-2133
Mailing Address - Country:US
Mailing Address - Phone:228-818-9191
Mailing Address - Fax:228-818-9193
Practice Address - Street 1:6912 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-2133
Practice Address - Country:US
Practice Address - Phone:228-818-9191
Practice Address - Fax:228-818-9193
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903711363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology