Provider Demographics
NPI:1396010070
Name:HIGHFIELD, MARY BETH (LPN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:BETH
Last Name:HIGHFIELD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 CLOVERLANE DR
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-9037
Mailing Address - Country:US
Mailing Address - Phone:740-727-2507
Mailing Address - Fax:
Practice Address - Street 1:2619 CLOVERLANE DR
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-9037
Practice Address - Country:US
Practice Address - Phone:740-727-2507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN146652MIV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse