Provider Demographics
NPI:1790742872
Name:HIGGINS, CHRISTINA LENA
Entity Type:Individual
Prefix:MR
First Name:CHRISTINA
Middle Name:LENA
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 1:302 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:OH
Mailing Address - Zip Code:43342-9711
Mailing Address - Country:US
Mailing Address - Phone:740-494-2792
Mailing Address - Fax:
Practice Address - Street 1:302 PARK AVE
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:OH
Practice Address - Zip Code:43342-9711
Practice Address - Country:US
Practice Address - Phone:740-494-2792
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2618822Medicaid