Individual
MISTY DANELLE POLSTON WHIPKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
21023
SC
363LF0000X
Family Nurse Practitioner
21023
SC
Other
Enumeration date
05/30/2017
Last updated
03/26/2024
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