Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | RN0573445 | OH |
NPI | 1285248880 |
---|---|
Provider Name | Kara C Little Whiteley |
First Address | Mason, OH 45040-1342 |
Second Address | Mason, OH 45040-1342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2020 |
Last Update Date | 02/09/2020 |