Doctor Name: | MR. TERRY LEE WHYTE |
NPI Number: | 1053319863 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | FNP-C |
License Number: | 4704209317 |
Business Practice Address: | 3650 Dixie Hwy Waterford, MI - 483294290 |
Business Phone Number: | 2486744630 |
Business Fax Number: | 2486747157 |
Mailing Address: | 3650 Dixie Hwy, WATERFORD |
State: | MI |
Postal Code: | 483294290 |
Phone Number: | 2486744630 |
Fax Number: | 2486747157 |
NPI Enumeration Date: | 07/14/2005 |
NPI Last Update Date: | 03/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704209317 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |