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NPI 1144767138

NPI 1144767138 : WHITNEY GARNER PA-C : BEDFORD, IN

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General NPI Number Information
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    NPI Number           |    1144767138
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    Entity Type          |    Individual 
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    Provider Name        |    WHITNEY GARNER PA-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/27/2017
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    Last Update Date     |    08/21/2020
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Provider Practice Location Address
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    Address Line         |    2900 16TH ST 
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    City                 |    BEDFORD
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    State                |    IN
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    Zip                  |    47421-3510
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    Country              |    US
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    Telephone            |    812-276-4496
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2900 16TH ST 
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    City                 |    BEDFORD
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    State                |    IN
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    Zip                  |    47421-3510
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    Country              |    US
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    Telephone            |    812-276-4496
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    085006111
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    License Number State |    IL
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Taxonomy #2
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    10002955A
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    License Number State |    IN
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