Basic Information
| Provider Information | |||||||||
| NPI: | 1578777017 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIGGINS | ||||||||
| FirstName: | KRISTEN | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 959 COX RD | ||||||||
| Address2: | |||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280543420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048667576 | ||||||||
| FaxNumber: | 7048660106 | ||||||||
| Practice Location | |||||||||
| Address1: | 959 COX RD | ||||||||
| Address2: | |||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280543420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048667576 | ||||||||
| FaxNumber: | 7048660106 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2007 | ||||||||
| LastUpdateDate: | 09/19/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 207N00000X | NC | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.