Individual
RENATA WHITLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3330 N 2ND ST STE 601, PHOENIX, AZ 85012-2395
(602) 230-7373
(602) 230-5105
Mailing address
3101 N CENTRAL AVE STE 550, PHOENIX, AZ 85012-2635
(602) 230-7373
(602) 682-7455
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
6790
AZ
363A00000X
Physician Assistant
Primary
6790
AZ
Other
Enumeration date
11/08/2017
Last updated
12/04/2023
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