Individual
LAURA WHITFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
520 DOUGLAS BLVD, TYLER, TX 75702-8307
(903) 510-8704
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
652110
TX
363L00000X
Nurse Practitioner
Primary
AP114321
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179541101
—
TX
05
—
179541102
—
TX
01
—
772600
MEDICARE
TX
01
—
P02207523
MEDICARE RAIL ROAD
TX
Enumeration date
03/19/2007
Last updated
12/30/2024
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