Provider Demographics
NPI:1982377420
Name:HIGHLEN, JADE (NP)
Entity type:Individual
Prefix:
First Name:JADE
Middle Name:
Last Name:HIGHLEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 HALL ST SW STE 263
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4988
Mailing Address - Country:US
Mailing Address - Phone:616-719-0919
Mailing Address - Fax:
Practice Address - Street 1:401 HALL ST SW STE 263
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4988
Practice Address - Country:US
Practice Address - Phone:616-204-0233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704367459363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner