MEDICARE: TINA D HIGHFILL FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	R676276	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	302I506854	OTHER	MS	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851364228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA D HIGHFILL FNP-BC

Provider Business Mailing Address
First Line	:	118 MULLHERRIN DR
Second Line	:
City	:	MADISON
State	:	MS
Zip	:	39110-4533
Country	:	US
Telephone Number	:	601-407-3226
Fax Number	:

Provider Business Practice Location Address
First Line	:	129 CENTER ST STE B
Second Line	:
City	:	RICHLAND
State	:	MS
Zip	:	39218-4800
Country	:	US
Telephone Number	:	769-233-7141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	10/22/2023

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