Healthcare Provider Details

I. General information

NPI: 1891600169
Provider Name (Legal Business Name): LORI WHITTINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5721 USA NORTH DRIVE
MOBILE AL
36688-0001
US

IV. Provider business mailing address

1074 BEALL RD
HAZLEHURST MS
39083-9420
US

V. Phone/Fax

Practice location:
  • Phone: 251-895-6388
  • Fax:
Mailing address:
  • Phone: 601-695-6123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number882614
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: