Provider Demographics
NPI:1750833646
Name:HIGHTOWER, ROSALYN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ROSALYN
Middle Name:
Last Name:HIGHTOWER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 WOOD DUCK CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-6115
Mailing Address - Country:US
Mailing Address - Phone:302-376-1877
Mailing Address - Fax:
Practice Address - Street 1:1213 CHURCHMANS RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2149
Practice Address - Country:US
Practice Address - Phone:302-894-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC50001018363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant