Provider Demographics
NPI:1881157980
Name:HIGGINS, BRENDAN MICAHEL
Entity type:Individual
Prefix:
First Name:BRENDAN
Middle Name:MICAHEL
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 ARRINGDON PARK DR STE 230
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5643
Mailing Address - Country:US
Mailing Address - Phone:919-684-2445
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:5601 ARRINGDON PARK DR STE 230
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-5643
Practice Address - Country:US
Practice Address - Phone:919-684-2445
Practice Address - Fax:615-221-9054
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP18835225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist