1093986143 NPI number — SARAH H HIGDON CRNA

Table of content: SARAH H HIGDON CRNA (NPI 1093986143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093986143 NPI number — SARAH H HIGDON CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HIGDON
Provider First Name:
SARAH
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HANKE
Provider Other First Name:
SARAH
Provider Other Middle Name:
P
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1093986143
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
255 W MICHIGAN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JACKSON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49201-2218
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-242-1131
Provider Business Mailing Address Fax Number:
517-787-4146

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2139 AUBURN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45219-2906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-585-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/17/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  RN.303488 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)