Doctor Name: | PAMELA J WHITLOCK |
NPI Number: | 1356417810 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 144642 |
Business Practice Address: | 4016 Main St Cassville, MO - 656259753 |
Business Phone Number: | 4178470057 |
Business Fax Number: | 4178470079 |
Mailing Address: | 4301 Doniphan Dr, NEOSHO |
State: | MO |
Postal Code: | 648509120 |
Phone Number: | 4174519450 |
Fax Number: | 4174518903 |
NPI Enumeration Date: | 11/27/2006 |
NPI Last Update Date: | 03/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 144642 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |