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General NPI Number Information
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NPI Number | 1245716836
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Entity Type | Individual
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Provider Name | HAYLIE WHITTENBURG APRN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 280 DUNDAS DR
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City | JACKSONVILLE
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State | FL
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Zip | 32218-5517
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Country | US
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Telephone | 904-751-4906
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Fax | 904-714-3574
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Provider Business Mailing Address
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Address Line | 705 WELLS RD STE 300
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City | ORANGE PARK
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State | FL
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Zip | 32073-2982
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Country | US
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Telephone | 904-751-4906
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Fax | 904-714-3574
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN9369686
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License Number State | FL
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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 | APRN9369686
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License Number State | FL
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