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General NPI Number Information
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NPI Number | 1962975664
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Entity Type | Individual
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Provider Name | THURITHABHANI UDATHARI WHITAKER CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/04/2019
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 1001 TOWSON AVE
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City | FORT SMITH
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State | AR
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Zip | 72901-4921
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Country | US
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Telephone | 479-441-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 MEETING HOUSE RD
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City | KNOXVILLE
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State | TN
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Zip | 37931-4428
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Country | US
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Telephone | 479-212-1538
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | C003266
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 124642
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3015692
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License Number State | KY
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