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General NPI Number Information
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NPI Number | 1194166728
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Entity Type | Individual
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Provider Name | KEREN ASHIE WHALEY NP
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Gender | Female
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Dates
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Enumeration Date | 07/11/2013
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 3123 N DAVIDSON ST STE 103
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City | CHARLOTTE
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State | NC
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Zip | 28205-1054
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Country | US
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Telephone | 252-470-6825
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Fax |
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Provider Business Mailing Address
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Address Line | 3123 N DAVIDSON ST STE 103
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City | CHARLOTTE
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State | NC
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Zip | 28205-1054
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Country | US
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Telephone | 980-621-6891
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 263822
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN274795
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00578900
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5006385
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License Number State | NC
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