Organization Name: | WHITEVILLE MEDICAL CLINIC, LLC |
NPI Number: | 1073754636 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEE BLAKNEY (DNP) |
Mailing Address: | 2060 Us Highway 64 Suite C Whiteville |
State: | TN US |
Postal Code: | 380757476 |
Phone Number: | 9016266626 |
Fax Number: | |
NPI Enumeration Date: | 03/11/2009 |
NPI Last Update Date: | 03/11/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |