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General NPI Number Information
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NPI Number | 1497213953
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Entity Type | Individual
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Provider Name | SEASON VIRGINIA WHITMORE FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 10/26/2020
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Provider Practice Location Address
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Address Line | 801 W TRADE ST
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City | CHARLOTTE
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State | NC
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Zip | 28202-1122
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Country | US
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Telephone | 980-598-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 1423 RED VENTURES DR
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City | INDIAN LAND
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State | SC
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Zip | 29707-5019
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Country | US
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Telephone | 704-244-3716
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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 | 22697
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License Number State | SC
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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 | 5011727
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License Number State | NC
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