Provider Demographics
NPI:1831504083
Name:AMY HIGGINS
Entity type:Organization
Organization Name:AMY HIGGINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:OUTLAW
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:706-323-3400
Mailing Address - Street 1:1900 11TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1868
Mailing Address - Country:US
Mailing Address - Phone:706-323-3400
Mailing Address - Fax:706-321-1684
Practice Address - Street 1:1900 11TH AVE STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1868
Practice Address - Country:US
Practice Address - Phone:706-323-3400
Practice Address - Fax:706-321-1684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN167875364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatricsGroup - Single Specialty