Individual
JOHANNA WHALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6606 LBJ FWY, 200, DALLAS, TX 75240-6533
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0865
(972) 715-5000
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP127232
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
343754301
—
TX
01
—
8614UJ
BCBS
TX
Enumeration date
01/16/2015
Last updated
06/30/2020
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