Provider Demographics
NPI:1053887059
Name:HIGGINS, ROKIA TIARA
Entity type:Individual
Prefix:
First Name:ROKIA
Middle Name:TIARA
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PATTERSON AVE E
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-5440
Mailing Address - Country:US
Mailing Address - Phone:857-417-3810
Mailing Address - Fax:
Practice Address - Street 1:1 PATTERSON AVE E
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-5440
Practice Address - Country:US
Practice Address - Phone:857-417-3810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN96572164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse