Doctor Name: | SUSAN WHATLEY |
NPI Number: | 1083072094 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | RN255455 |
Business Practice Address: | 636 Del Prado Blvd S Cape Coral, FL - 339902668 |
Business Phone Number: | 2394242120 |
Business Fax Number: | |
Mailing Address: | 636 Del Prado Blvd S, CAPE CORAL |
State: | FL |
Postal Code: | 339902668 |
Phone Number: | 2394242120 |
Fax Number: | |
NPI Enumeration Date: | 02/04/2016 |
NPI Last Update Date: | 02/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN255455 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |