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Individual
KRISTY M WHELAN
Active
Individual
KRISTY M WHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3773
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
701632
—
AZ
01
—
AZ0422120
BLUE CROSS BLUE SHIELD #
AZ
01
—
Z108996
MEDICARE GROUP PTAN
AZ
01
—
Z108997
MEDICARE INDIVIDUAL PTAN
AZ
Enumeration date
09/14/2006
Last updated
02/09/2016
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