Individual
KENNETH JORDAN WHITING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
600 EAST BLVD, ELKHART, IN 46514-2483
(574) 294-2621
Mailing address
PO BOX 2127, ATHENS, TX 75751-7127
(903) 677-7434
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
28221435A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
AP137579
TX
367500000X
Certified Registered Nurse Anesthetist
RN159833
AZ
Other
Enumeration date
05/06/2015
Last updated
07/12/2018
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