Provider Demographics
NPI:1376615278
Name:KAREN HIGGINS NILES INC
Entity type:Organization
Organization Name:KAREN HIGGINS NILES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGGINS NILES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-929-3972
Mailing Address - Street 1:PO BOX 5096
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88102
Mailing Address - Country:US
Mailing Address - Phone:303-929-3972
Mailing Address - Fax:
Practice Address - Street 1:921 E 21ST ST
Practice Address - Street 2:STE D
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101
Practice Address - Country:US
Practice Address - Phone:505-762-0212
Practice Address - Fax:505-762-0660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD200604972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty