1710053194 NPI number — KATHI M HIGHFIELD PT

Table of content: KATHI M HIGHFIELD PT (NPI 1710053194)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710053194 NPI number — KATHI M HIGHFIELD PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HIGHFIELD
Provider First Name:
KATHI
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

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

NPI Number Information

NPI Number:
1710053194
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1723 BESLEY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VIENNA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22182-2005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-255-3483
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7143 SHREVE RD
Provider Second Line Business Practice Location Address:
ACHIEVE BEYOND
Provider Business Practice Location Address City Name:
FALLS CHURCH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-237-2219
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/28/2006

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: 2251P0200X , with the licence number:  2305000939 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: U02178665 02 . This is a "CIGNA INSURANCE ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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