Individual
MS. ANGIE MICHELLE WHITEHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
109 E QUITMAN ST, IUKA, MS 38852-1936
(662) 423-5007
(662) 423-5007
Mailing address
109 E QUITMAN ST, IUKA, MS 38852-1936
(662) 423-5007
(662) 423-5050
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R851652
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07837508
—
MS
01
—
35824
TLC
—
01
—
R851652
MS. BOARD OF NURSING
MS
Enumeration date
08/23/2006
Last updated
03/07/2023
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