Provider Demographics
NPI:1538101621
Name:HIGHSMITH, CAROLYN ANITA (RN,MSN-ANP, APRN, BC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ANITA
Last Name:HIGHSMITH
Suffix:
Gender:F
Credentials:RN,MSN-ANP, APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 ANDERSON DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON-SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-5101
Mailing Address - Country:US
Mailing Address - Phone:336-788-8856
Mailing Address - Fax:
Practice Address - Street 1:WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER
Practice Address - Street 2:MEDICAL CENTER BLVD.
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157
Practice Address - Country:US
Practice Address - Phone:336-713-5681
Practice Address - Fax:336-713-5677
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC131961 RN; 900432 NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7003642Medicaid
NC7000494Medicaid
NC7003642Medicaid
NCQ18287Medicare UPIN
NC7000494Medicaid