Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 226885 | TX |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP100842 | TX |
N | 363LW0102X | Nurse Practitioner - Women's Health | 226885 | TX |
NPI | 1093741811 |
---|---|
Provider Name | Ms. Sherry Suzan Whiteaker |
First Address | Muleshoe, TX 79347-3627 |
Second Address | Muleshoe, TX 79347-3625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 15/07/2014 |