Provider Demographics
NPI:1275824203
Name:HIGH, LORI KATHRYN (FNP-BC, GNP-BC)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:KATHRYN
Last Name:HIGH
Suffix:
Gender:F
Credentials:FNP-BC, GNP-BC
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:RICHMOND
Other - Last Name:HIGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC, GNP-BC
Mailing Address - Street 1:2910 FANNIN ST
Mailing Address - Street 2:STE B
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-3901
Mailing Address - Country:US
Mailing Address - Phone:469-800-1150
Mailing Address - Fax:469-800-1165
Practice Address - Street 1:2120 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 515
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2221
Practice Address - Country:US
Practice Address - Phone:469-800-1150
Practice Address - Fax:469-800-1165
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253970363LF0000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX271797YKY6Medicare PIN