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General NPI Number Information
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NPI Number | 1528049541
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Entity Type | Organization
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Legal Business Name | WHITAKER NATIONAL CORPORATION
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 06/28/2018
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Provider Practice Location Address
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Address Line | THREE RIVERS MEDICAL CENTER 2483 HIGHWAY 644
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City | LOUISA
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State | KY
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Zip | 41230
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Country | US
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Telephone | 606-638-9451
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 936434
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City | ATLANTA
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State | GA
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Zip | 31193-6434
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Country | US
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Telephone | 800-377-8721
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Fax | 304-697-1155
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Authorized Official
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Title or Position | CFO
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Name | JENNIFER MOORE
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Credential |
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Telephone | 415-435-4591
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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