Healthcare Provider Details

I. General information

NPI: 1932455425
Provider Name (Legal Business Name): MELISSA P WHITNEY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 LIBERTY ST
CLAY CENTER KS
67432-1564
US

IV. Provider business mailing address

485 N KS HWY 2
ANTHONY KS
67003-2526
US

V. Phone/Fax

Practice location:
  • Phone: 785-632-2144
  • Fax:
Mailing address:
  • Phone: 620-914-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number15-01552
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: