Provider Demographics
NPI:1376143107
Name:HIGHLEY, ELIZABETH ANN
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:HIGHLEY
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:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:GRATIS
Mailing Address - State:OH
Mailing Address - Zip Code:45330-0062
Mailing Address - Country:US
Mailing Address - Phone:937-231-7082
Mailing Address - Fax:
Practice Address - Street 1:404 SOUTH ADA DOTY ST.
Practice Address - Street 2:
Practice Address - City:GRATIS
Practice Address - State:OH
Practice Address - Zip Code:45330
Practice Address - Country:US
Practice Address - Phone:937-231-7082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide