Healthcare Provider Details

I. General information

NPI: 1114475357
Provider Name (Legal Business Name): KATHERINE HINTON WHITMIRE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE HINTON APRN

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6355 S BUFFALO DR FL 3
LAS VEGAS NV
89113-2133
US

IV. Provider business mailing address

6355 S BUFFALO DR FL 3
LAS VEGAS NV
89113-2133
US

V. Phone/Fax

Practice location:
  • Phone: 702-479-4881
  • Fax: 702-966-8662
Mailing address:
  • Phone: 702-216-3346
  • Fax: 702-671-6883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN90934
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number227390
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberAPRN002439
License Number StateNV
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN002439
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: