Individual
MRS. TRACY WHITMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
700 QUINCY AVE, SCRANTON, PA 18510-1724
(866) 519-0457
(570) 770-5263
Mailing address
5 ALPHA CT, SCRANTON, PA 18508-1603
(570) 840-1365
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
SP019789
PA
363LP0200X
Pediatric Nurse Practitioner
Primary
SP019920
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1036780850001
—
PA
05
—
1036780850002
—
PA
Enumeration date
05/17/2019
Last updated
01/23/2024
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