Provider Demographics
NPI:1932634524
Name:HIGHSMITH, KAYLEE (MA)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:HIGHSMITH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 WILLIAMSBURG DR
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-4851
Mailing Address - Country:US
Mailing Address - Phone:440-670-3664
Mailing Address - Fax:
Practice Address - Street 1:524 JAMES WAY
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-7801
Practice Address - Country:US
Practice Address - Phone:740-389-6036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program