Individual
KAY C WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1300 E CENTER ST, PROVO, UT 84606-3554
(801) 344-4400
Mailing address
PO BOX 270, PROVO, UT 84603-0270
(801) 344-4400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
192744-4405
UT
363LF0000X
Family Nurse Practitioner
Primary
192744-4405-20140124
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1
—
UT
Enumeration date
06/02/2006
Last updated
04/22/2019
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