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Individual
LYNN A WHITTAKER
Active
Individual
LYNN A WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71001064A
IN
363LA2200X
Adult Health Nurse Practitioner
71001064A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000343441
ANTHEM
—
05
—
200338530
—
IN
01
—
78013505
KY MEDICAID
KY
Enumeration date
12/04/2006
Last updated
01/09/2013
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