Provider Demographics
NPI:1891241790
Name:HIGGINS, TRACY (APRN, ACNP)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:APRN, ACNP
Other - Prefix:MS
Other - First Name:TRACY
Other - Middle Name:
Other - Last Name:KIEHNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:200 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905-0001
Mailing Address - Country:US
Mailing Address - Phone:507-284-2511
Mailing Address - Fax:
Practice Address - Street 1:200 1ST ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0001
Practice Address - Country:US
Practice Address - Phone:507-284-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4728363L00000X
MNR-120882-7282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access