Provider Demographics
NPI:1346075470
Name:HIGHBAUGH, NESHEA R
Entity type:Individual
Prefix:
First Name:NESHEA
Middle Name:R
Last Name:HIGHBAUGH
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 1:12228 MIRIAM CT
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-9436
Mailing Address - Country:US
Mailing Address - Phone:463-207-0913
Mailing Address - Fax:800-762-0433
Practice Address - Street 1:12228 MIRIAM CT
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-9436
Practice Address - Country:US
Practice Address - Phone:463-207-0913
Practice Address - Fax:800-762-0433
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN5310201893172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver