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General NPI Number Information
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NPI Number | 1427042548
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Entity Type | Individual
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Provider Name | CONNIE S WHITESELL NP
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Gender | Female
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 05/27/2022
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Provider Practice Location Address
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Address Line | 320 N OAK AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-2440
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Country | US
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Telephone | 931-528-5547
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Fax | 931-526-2699
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Provider Business Mailing Address
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Address Line | 140 W 7TH ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-1726
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Country | US
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Telephone | 931-783-5582
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Fax | 931-526-6760
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APN6705
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License Number State | TN
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