Individual
MRS. CONNIE S WHITESELL
Active
Individual
MRS. CONNIE S WHITESELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APN6705
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3378641
—
TN
01
—
4006810
BLUE CROSS BLUE SHEILD
TN
01
—
500014818
RAILROAD MEDICARE
TN
Enumeration date
09/02/2005
Last updated
05/27/2022
Update your record
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