Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | R0076753 | OK |
NPI | 1003219379 |
---|---|
Provider Name | Mrs. April Dawn Whitacre |
First Address | Talihina, OK 74571-2022 |
Second Address | Talihina, OK 74571-2022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2014 |
Last Update Date | 08/10/2021 |