Basic Information
Provider Information
NPI: 1811258296
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HIGLEY
FirstName: MEGHAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 11995 SINGLETREE LN STE 500
Address2:  
City: EDEN PRAIRIE
State: MN
PostalCode: 553445349
CountryCode: US
TelephoneNumber: 9525951301
FaxNumber: 6122944903
Practice Location
Address1: 11995 SINGLETREE LN STE 500
Address2:  
City: EDEN PRAIRIE
State: MN
PostalCode: 553445349
CountryCode: US
TelephoneNumber: 9525951301
FaxNumber: 6122944903
Other Information
ProviderEnumerationDate: 06/01/2012
LastUpdateDate: 02/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XPG163013ORN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202XMD181611ORY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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