Individual
GERALDINE KOKOTT HIGHSMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4201 LAKE BOONE TRAIL, SUITE 4, RALEIGH, NC 27607-7511
(919) 781-4434
(919) 781-5851
Mailing address
4201 LAKE BOONE TRAIL, SUITE 4, RALEIGH, NC 27607-7511
(919) 781-4434
(919) 781-5851
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1184
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07982
BCBS
NC
01
—
4613492
AETNA
—
01
—
6400040
UNITED HEALTHCARE
—
05
—
7207982
—
NC
01
—
8300041K
MEDICAID CBRS
NC
01
—
C3555
MEDCOST
—
Enumeration date
12/26/2006
Last updated
07/08/2007
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