Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 3012223 | KY |
NPI | 1003312075 |
---|---|
Provider Name | Whitney Dawn Spear |
First Address | Chicago, IL 60677-6351 |
Second Address | Louisville, KY 40202-3900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2018 |
Last Update Date | 21/12/2021 |