Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 2018027760 | MO |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 2018027760 | MO |
NPI | 1043796444 |
---|---|
Provider Name | Stephanie Ann Whitbey |
First Address | Columbia, MO 65201-5844 |
Second Address | Columbia, MO 65201-5844 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2018 |
Last Update Date | 26/12/2018 |