Provider Demographics
NPI:1083830210
Name:HIGNEY, KIMBERLY TANYA (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:TANYA
Last Name:HIGNEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 GREAT BAY DR E
Mailing Address - Street 2:
Mailing Address - City:GREENLAND
Mailing Address - State:NH
Mailing Address - Zip Code:03840-2143
Mailing Address - Country:US
Mailing Address - Phone:603-433-8417
Mailing Address - Fax:866-603-1127
Practice Address - Street 1:390 PORTSMOUTH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:GREENLAND
Practice Address - State:NH
Practice Address - Zip Code:03840-2222
Practice Address - Country:US
Practice Address - Phone:603-433-2023
Practice Address - Fax:866-565-9851
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH719-0404111N00000X
MA3038111N00000X
OH3490111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y45822Medicare ID - Type Unspecified
U99771Medicare UPIN