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General NPI Number Information
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NPI Number | 1477523959
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Entity Type | Individual
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Provider Name | JONI DIANNE WHITEHEAD FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 567 WALKER ST
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City | MERRYVILLE
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State | LA
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Zip | 70653-3040
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Country | US
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Telephone | 337-825-1728
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Fax | 337-825-1229
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Provider Business Mailing Address
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Address Line | 567 WALKER ST
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City | MERRYVILLE
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State | LA
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Zip | 70653-3040
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Country | US
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Telephone | 337-825-1728
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Fax | 337-825-1229
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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 | 78494-3569
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License Number State | LA
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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 | 673697
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License Number State | TX
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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 | AP03569
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License Number State | LA
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