Provider Demographics
NPI:1194431239
Name:HIGHSTONE, CAROLYN JOHNSTON
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JOHNSTON
Last Name:HIGHSTONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6429 BANNINGTON RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-1344
Mailing Address - Country:US
Mailing Address - Phone:704-503-9338
Mailing Address - Fax:704-503-9339
Practice Address - Street 1:6429 BANNINGTON RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-1344
Practice Address - Country:US
Practice Address - Phone:704-503-9338
Practice Address - Fax:704-503-9339
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017368363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health