Individual
DEAN E WHITLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
794 HIGHWAY 51, SUITE D, MADISON, MS 39110-9662
(601) 853-8814
(601) 853-8816
Mailing address
PO BOX 2742, MADISON, MS 39130-2742
(601) 853-8814
(601) 853-8816
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R613053
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01656530
—
MS
Enumeration date
07/31/2006
Last updated
07/08/2007
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