Individual
DR. KELLY LYNN WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD, CDE
Contact information
Practice address
2670 NEW HOLT RD STE D, PADUCAH, KY 42001-7506
(270) 444-7070
Mailing address
2670 NEW HOLT RD STE D, PADUCAH, KY 42001-7506
(270) 444-7070
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
20410432
KY
183500000X
Pharmacist
011861
KY
Other
Enumeration date
10/22/2008
Last updated
12/04/2019
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