Provider Demographics
NPI:1659106854
Name:HIGLEY, SAVANNAH KRISTINE
Entity type:Individual
Prefix:MRS
First Name:SAVANNAH
Middle Name:KRISTINE
Last Name:HIGLEY
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 1:588 CANYON DR
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-4844
Mailing Address - Country:US
Mailing Address - Phone:208-380-3291
Mailing Address - Fax:
Practice Address - Street 1:588 CANYON DR
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-4844
Practice Address - Country:US
Practice Address - Phone:208-380-3291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility