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General NPI Number Information
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NPI Number | 1407108954
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Entity Type | Individual
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Provider Name | VONNY WHITTINGTON
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Gender | Female
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Dates
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Enumeration Date | 10/09/2012
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Last Update Date | 05/17/2024
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Provider Practice Location Address
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Address Line | 101 JOHN ST
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City | LAKE CITY
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State | SC
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Zip | 29560-2411
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Country | US
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Telephone | 843-394-2031
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Fax |
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Provider Business Mailing Address
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Address Line | 1075 STATE HWY 247
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City | CORONA
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State | NM
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Zip | 88318
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Country | US
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Telephone | 803-720-1817
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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 | 18011
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License Number State | SC
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