Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP4405 | AZ |
NPI | 1043584857 |
---|---|
Provider Name | Katherine Whitney |
First Address | Tucson, AZ 85724-0001 |
Second Address | Tucson, AZ 85724-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2012 |
Last Update Date | 23/06/2014 |