Healthcare Provider Details

I. General information

NPI: 1114679487
Provider Name (Legal Business Name): MEGHAN LEAH WHIPPLE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 16TH ST STE 7
BAY CITY MI
48708-7609
US

IV. Provider business mailing address

2503 W LUDINGTON DR
FARWELL MI
48622-9759
US

V. Phone/Fax

Practice location:
  • Phone: 989-667-2322
  • Fax: 989-667-2327
Mailing address:
  • Phone: 517-899-1495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number4704340511
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: