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Individual

CODY WHITTINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
149 ROGERS AVE, SUMMERSVILLE, MO 65571
(417) 932-4119
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019035278
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
420077940
MO
Enumeration date
11/19/2019
Last updated
01/17/2023
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