Healthcare Provider Details

I. General information

NPI: 1679961429
Provider Name (Legal Business Name): HEATHER WHITMER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER MCDONALD PA

II. Dates (important events)

Enumeration Date: 01/02/2015
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 S UTICA AVE STE 105
TULSA OK
74104-4243
US

IV. Provider business mailing address

1265 S UTICA AVE STE 105
TULSA OK
74104-4243
US

V. Phone/Fax

Practice location:
  • Phone: 918-592-0999
  • Fax:
Mailing address:
  • Phone: 918-592-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number51894
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: