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General NPI Number Information
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NPI Number | 1174489603
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Entity Type | Individual
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Provider Name | FRIDEA WHITBY MSN, APRN, PMHNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 3100 RIDGE AVE
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City | MACON
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State | GA
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Zip | 31204-2312
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Country | US
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Telephone | 478-745-9206
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Fax | 250-999-6620
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Provider Business Mailing Address
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Address Line | 786 IVY BROOK WAY
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City | MACON
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State | GA
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Zip | 31210-5528
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Country | US
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Telephone | 478-952-9984
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | RN283976
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License Number State | GA
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