1144289463 NPI number — JODI A. CARNER-HIGGINS ARNP

Table of content: JODI A. CARNER-HIGGINS ARNP (NPI 1144289463)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144289463 NPI number — JODI A. CARNER-HIGGINS ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARNER-HIGGINS
Provider First Name:
JODI
Provider Middle Name:
A.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARNER
Provider Other First Name:
JODI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144289463
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
445 CYPRESS STREET, SUITE 8
Provider Second Line Business Mailing Address:
MANCHESTER COUNSELING SERVICES
Provider Business Mailing Address City Name:
MANCHESTER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-668-4079
Provider Business Mailing Address Fax Number:
603-663-8605

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
445 CYPRESS STREET, SUITE 8
Provider Second Line Business Practice Location Address:
MANCHESTER COUNSELING SERVICES
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-668-4079
Provider Business Practice Location Address Fax Number:
603-663-8605
Provider Enumeration Date:
03/23/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  027179-23-08 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4005241Y0NH02 . This is a "ANTHEM ACES #" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 66502 . This is a "CIGNA BH PIN" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30007795 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".