Healthcare Provider Details

I. General information

NPI: 1265734081
Provider Name (Legal Business Name): WHITNEY M BECHTEL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WHITNEY B MEDLEY CRNA

II. Dates (important events)

Enumeration Date: 11/30/2010
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 MEDICAL CENTER DR SUITE 105
PADUCAH KY
42003-7914
US

IV. Provider business mailing address

PO BOX 636961
CINCINNATI OH
45263-6961
US

V. Phone/Fax

Practice location:
  • Phone: 270-441-4500
  • Fax: 270-441-4289
Mailing address:
  • Phone: 513-981-5130
  • Fax: 513-981-5015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0000158597
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN0000015356
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024169345
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3008518
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: