Healthcare Provider Details

I. General information

NPI: 1063501344
Provider Name (Legal Business Name): KELLI B WHITTED NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 VETERAN'S MEMORIAL DR. 206 JONES HALL
TROY AL
36082
US

IV. Provider business mailing address

327 VETERAN'S MEMORIAL DR. 206 JONES HALL
TROY AL
36082
US

V. Phone/Fax

Practice location:
  • Phone: 334-670-3428
  • Fax: 334-670-3744
Mailing address:
  • Phone: 334-670-3428
  • Fax: 334-670-3744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberRN117775
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: