Provider Demographics
NPI:1457350019
Name:HIGH, MARY A (RN, MSN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:HIGH
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:MCGINLEY HIGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN, MSN
Mailing Address - Street 1:PO BOX 34283
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0620
Mailing Address - Country:US
Mailing Address - Phone:302-660-7302
Mailing Address - Fax:302-660-7516
Practice Address - Street 1:4512 KIRKWOOD HWY STE 205
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5123
Practice Address - Country:US
Practice Address - Phone:302-660-7302
Practice Address - Fax:302-660-7516
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELB0000230363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001176442Medicaid
DE0001176442Medicaid
DES95845Medicare UPIN