MEDICARE: WHITNEY GIROUARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11029486	FL

General Provider Information

NPI Number	:	1588421127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY GIROUARD

Provider Business Mailing Address
First Line	:	7210 LAKE ENDERLY BLVD
Second Line	:
City	:	BARTOW
State	:	FL
Zip	:	33830-9004
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	851 CHALET SUZANNE RD
Second Line	:
City	:	LAKE WALES
State	:	FL
Zip	:	33859-7759
Country	:	US
Telephone Number	:	863-679-9916
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/29/2024
Last Update Date	:	07/31/2024

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Directions to “ WHITNEY GIROUARD ” Practice Location

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