Provider Demographics
NPI:1851038889
Name:HIGGINBOTHAM-BUTTRILL, DONNA LYNN
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:LYNN
Last Name:HIGGINBOTHAM-BUTTRILL
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 1:106 HERBERTA
Mailing Address - Street 2:
Mailing Address - City:POTTSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75076
Mailing Address - Country:US
Mailing Address - Phone:903-744-5294
Mailing Address - Fax:903-786-6234
Practice Address - Street 1:106 HERBERTA
Practice Address - Street 2:
Practice Address - City:POTTSBORO
Practice Address - State:TX
Practice Address - Zip Code:75076
Practice Address - Country:US
Practice Address - Phone:903-744-5294
Practice Address - Fax:903-786-6234
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility