Individual
ANN E WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3480 WAKE FOREST RD, SUITE 500, RALEIGH, NC 27609-7376
(919) 862-5650
Mailing address
4101 N ROXBORO ST, DURHAM, NC 27704-2121
(919) 684-8111
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
103102
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0656817
UNITED HEALTHCARE
NC
01
—
79535
BLUE CROSS BLUE SHEILD NC
NC
05
—
8979535
—
NC
01
—
970017587
RAILROAD MEDICARE
NC
01
—
A5441
MEDCOST
NC
Enumeration date
02/15/2006
Last updated
08/12/2008
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