Healthcare Provider Details

I. General information

NPI: 1306238035
Provider Name (Legal Business Name): ALICIA S WHITLEY MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2015
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 E SPRING ST
MONROE GA
30655-2469
US

IV. Provider business mailing address

1016 E SPRING ST
MONROE GA
30655-2469
US

V. Phone/Fax

Practice location:
  • Phone: 770-464-0280
  • Fax: 770-464-0233
Mailing address:
  • Phone: 770-464-0280
  • Fax: 770-464-0233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberGAA-NP001598
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number162858
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number29124
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: