Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 0029380 | OK |
NPI | 1659538122 |
---|---|
Provider Name | Mrs. Diane Elizabeth Whipps |
First Address | Mcalester, OK 74501 |
Second Address | Mcalester, OK 74501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 21/05/2008 |