Provider Demographics
NPI:1962527325
Name:HIGLEY UNIFIED SCHOOL DISTRICT
Entity type:Organization
Organization Name:HIGLEY UNIFIED SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH PROVIDER SCHOOL NURSE OFFICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORA
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:TOTZAUER-SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:480-279-7615
Mailing Address - Street 1:2506 S SARANAC
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-6648
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3333 E VEST AVE
Practice Address - Street 2:
Practice Address - City:HIGLEY
Practice Address - State:AZ
Practice Address - Zip Code:85236-5424
Practice Address - Country:US
Practice Address - Phone:480-279-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN166547251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ726739Medicaid