Provider Demographics
NPI:1023052305
Name:HIGGINS, ROBERTA B (APRN)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:B
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 EASTERN BYP STE 5
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2406
Mailing Address - Country:US
Mailing Address - Phone:859-624-2229
Mailing Address - Fax:859-625-9458
Practice Address - Street 1:795 EASTERN BYP STE 5
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2406
Practice Address - Country:US
Practice Address - Phone:859-624-2229
Practice Address - Fax:859-625-9458
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2084M367A00000X
OHRN.303543367A00000X
KY3002084363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000300482OtherANTHEM-BC/BS
KY7876109OtherAETNA
KY78001773Medicaid
KY78001773Medicaid