Provider Demographics
NPI:1770524621
Name:HIGNIGHT, PAMELA DAWN (MS, RD, LD)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:DAWN
Last Name:HIGNIGHT
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:MS
Other - First Name:PAMELA
Other - Middle Name:DAWN
Other - Last Name:BLACKMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,RD,LD
Mailing Address - Street 1:1986 COUNTY ROAD 4990
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75783-4702
Mailing Address - Country:US
Mailing Address - Phone:903-967-2238
Mailing Address - Fax:903-967-2238
Practice Address - Street 1:1205 E MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5649
Practice Address - Country:US
Practice Address - Phone:903-247-8262
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA32133V00000X
TXDT01201133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered