Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 1-047827 | AL |
NPI | 1083923031 |
---|---|
Provider Name | Euveta Fran Whitlock |
First Address | Montgomery, AL 36104-3735 |
Second Address | Robertsdale, AL 36567 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2010 |
Last Update Date | 24/09/2010 |