Doctor Name: | SHANDI WHISENANT |
NPI Number: | 1861837437 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | 1-109636 |
Business Practice Address: | 1083 E Relham Ave Loxley, AL - 365512406 |
Business Phone Number: | 2519644011 |
Business Fax Number: | |
Mailing Address: | 2 Watch Tower, SPANISH FORT |
State: | AL |
Postal Code: | 365273007 |
Phone Number: | 2513673760 |
Fax Number: | |
NPI Enumeration Date: | 05/08/2013 |
NPI Last Update Date: | 06/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1-109636 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |