| NPI | 1134764608 |
|---|---|
| Former Name | SHANNON MARIE HIGGINBOTHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-113275) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 113275) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 32107) | |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2023-08-16 |