Provider Demographics
NPI:1851364228
Name:HIGHFILL, TINA D (FNP-BC)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:D
Last Name:HIGHFILL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 MULLHERRIN DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-4533
Mailing Address - Country:US
Mailing Address - Phone:601-407-3226
Mailing Address - Fax:
Practice Address - Street 1:129 CENTER ST STE B
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MS
Practice Address - Zip Code:39218-4800
Practice Address - Country:US
Practice Address - Phone:769-233-7141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2023-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR676276363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS302I506854OtherMEDICARE
MS00123299Medicaid
MSP16979Medicare UPIN