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General NPI Number Information
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NPI Number | 1720616196
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Entity Type | Individual
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Provider Name | WHITNEY STIDHAM APRN
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Gender | Female
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 617 23RD ST STE 19
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City | ASHLAND
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State | KY
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Zip | 41101-2845
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Country | US
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Telephone | 63-252-2216
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Fax |
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Provider Business Mailing Address
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Address Line | 1480 CARTER AVE
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City | ASHLAND
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State | KY
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Zip | 41101-7546
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Country | US
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Telephone | 606-316-2199
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Fax | 606-325-0857
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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 | APRN11004302
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3017487
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License Number State | KY
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