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General NPI Number Information
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NPI Number | 1639558083
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Entity Type | Individual
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Provider Name | DEVIN MILES WHITEHEAD APRN
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Gender | Male
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Dates
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Enumeration Date | 05/19/2015
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 858 EASTERN BYP
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City | RICHMOND
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State | KY
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Zip | 40475-2512
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Country | US
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Telephone | 859-626-0072
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Fax | 859-626-9684
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Provider Business Mailing Address
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Address Line | 858 EASTERN BYP
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City | RICHMOND
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State | KY
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Zip | 40475-2512
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Country | US
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Telephone | 859-626-0072
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Fax | 859-626-9684
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3009392
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License Number State | KY
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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 | 3009392
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License Number State | KY
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