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Individual

WHITNEY ANN WHITAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
211 FOUNTAIN CT STE 220, LEXINGTON, KY 40509-2696
(859) 629-7265
(859) 629-7266
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7825

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2553
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100633320
KY
Enumeration date
10/14/2019
Last updated
05/27/2021
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