Healthcare Provider Details

I. General information

NPI: 1043035546
Provider Name (Legal Business Name): JULIE WHITAKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 W 15TH ST
PLANO TX
75075-7753
US

IV. Provider business mailing address

PO BOX 911230
DALLAS TX
75391-1230
US

V. Phone/Fax

Practice location:
  • Phone: 972-867-3577
  • Fax: 972-985-9433
Mailing address:
  • Phone: 972-997-8000
  • Fax: 972-234-0813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1178809
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: