Individual
CARLA WHITFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
598 W 11TH AVE, LUMBERTON, MS 39455-2350
(601) 545-8700
(601) 582-5461
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-8700
(601) 582-5461
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R714232
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00201796
—
MS
01
—
1144085
WINDSOR HEALTH GROUP
MS
01
—
29391 S
HUMANA/TRICARE
MS
01
—
7484916
AETNA
MS
01
—
8208387P01
CIGNA
MS
01
—
P00726914
RAILROAD MEDICARE
MS
Enumeration date
05/11/2006
Last updated
07/07/2011
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