Individual
MS. DONNA WHITLOCK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
317 WESTERN BLVD, JACKSONVILLE, NC 28546-6338
(910) 577-4740
(910) 577-2575
Mailing address
138 LESLIE DR, HUBERT, NC 28539-3745
(910) 389-9797
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
026851
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00007
BLUE CROSS
NC
05
—
3400042
—
NC
Enumeration date
05/20/2006
Last updated
07/08/2007
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