Provider Demographics
NPI:1487033072
Name:HIGH, RAE ANN (MS, AGNP-C)
Entity type:Individual
Prefix:
First Name:RAE
Middle Name:ANN
Last Name:HIGH
Suffix:
Gender:F
Credentials:MS, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21942 EDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-9723
Mailing Address - Country:US
Mailing Address - Phone:941-505-2100
Mailing Address - Fax:941-505-6100
Practice Address - Street 1:21942 EDGEWATER DR
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-9723
Practice Address - Country:US
Practice Address - Phone:941-505-2100
Practice Address - Fax:941-505-6100
Is Sole Proprietor?:No
Enumeration Date:2015-05-28
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1014742363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003XXOtherBC/BS GROUP
FLDS5131OtherRR MEDICARE GROUP
FLIF712ZOtherMEDICARE
FLP01581693OtherRR MEDICARE
FLY0RX4OtherBC/BS
FLFB001AOtherMEDICARE GROUP