Healthcare Provider Details

I. General information

NPI: 1588051023
Provider Name (Legal Business Name): WHITNEY ANDREW PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2015
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 FORTUNES RIDGE DR
DURHAM NC
27713-6102
US

IV. Provider business mailing address

6456 CODY ACRES TRL
HURDLE MILLS NC
27541-7414
US

V. Phone/Fax

Practice location:
  • Phone: 919-391-7202
  • Fax:
Mailing address:
  • Phone: 919-769-6410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-05663
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: