Healthcare Provider Details

I. General information

NPI: 1326744996
Provider Name (Legal Business Name): ABIGAIL GRACE WHITT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ABIGAIL GRACE OSBORNE FNP

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

388 BEN BOLT AVE
TAZEWELL VA
24651-5386
US

IV. Provider business mailing address

213 S JEFFERSON ST STE 1006
ROANOKE VA
24011-1713
US

V. Phone/Fax

Practice location:
  • Phone: 276-988-8850
  • Fax: 276-988-6050
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024186050
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: