Individual
AMELIA KAIDI WHITLATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
6611 CLYO RD, STE E, CENTERVILLE, OH 45459-2785
(937) 208-8282
(937) 208-8275
Mailing address
6611 CLYO RD, STE E, CENTERVILLE, OH 45459-2785
(937) 208-8282
(937) 208-8275
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA.12753-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0059561
—
OH
Enumeration date
09/27/2011
Last updated
01/02/2020
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