Provider Demographics
NPI:1902828494
Name:HIGGINS, JULIE ANNE (CRNA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5209 CLARENDON CREST CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2608
Mailing Address - Country:US
Mailing Address - Phone:248-851-7046
Mailing Address - Fax:248-851-3264
Practice Address - Street 1:5209 CLARENDON CREST CT
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-2608
Practice Address - Country:US
Practice Address - Phone:248-851-7046
Practice Address - Fax:248-851-3264
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2009-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704228635367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered