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Individual
TONYA WHITAKER
Active
Individual
TONYA WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28157720A
IN
363LF0000X
Family Nurse Practitioner
Primary
71007095A
IN
363LP0200X
Pediatric Nurse Practitioner
71007095A
IN
Other
Enumeration date
04/19/2017
Last updated
09/11/2023
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