Provider Demographics
NPI:1861901506
Name:HIGGS, AMANDA C (NP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:C
Last Name:HIGGS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:COFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2913 VALLEY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2678
Mailing Address - Country:US
Mailing Address - Phone:540-678-0792
Mailing Address - Fax:540-678-0795
Practice Address - Street 1:500 PEGASUS CT
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-4596
Practice Address - Country:US
Practice Address - Phone:540-313-4196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-26
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175400363LF0000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine