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Provider Information for 1104327790

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

JACY LAINE HIGBY PA-C

Gender: FEMALE

Individual NPI: 1104327790

Calendar   Last Updated:  2019-10-02
  Certification Date: 

Details

Name Value
NPI 1104327790
Enumeration Date 2018-02-28
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 38135 MARKET SQ
ZEPHYRHILLS, FL 33542-7505
United States

Phone: 352-567-0188 | Fax: 813-355-5101
View Map External Link
Primary Practice Address 2352 BRUCE B DOWNS BLVD STE 102
WESLEY CHAPEL, FL 33544-9203
United States

Phone: 813-979-0440 | Fax: 813-355-5054
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 363A00000X - Physician Assistant FL PA91100901