Individual
STEPHANIE P WHITLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1119 HIGHLAND AVE STE 10, CLARKSTON, WA 99403-2836
(509) 758-1450
Mailing address
3814 13TH STREET D, LEWISTON, ID 83501-5704
(208) 305-0742
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AP61601853
WA
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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