MEDICARE: JOY BERNICE WHALEY NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	RN018253NP	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023232188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY BERNICE WHALEY NP

Provider Business Mailing Address
First Line	:	388 BEAVERDALE RD NE
Second Line	:
City	:	DALTON
State	:	GA
Zip	:	30721-8015
Country	:	US
Telephone Number	:	706-259-5508
Fax Number	:	706-281-2325

Provider Business Practice Location Address
First Line	:	808 PROFESSIONAL BLVD
Second Line	:
City	:	DALTON
State	:	GA
Zip	:	30720-2536
Country	:	US
Telephone Number	:	706-226-2621
Fax Number	:	706-281-2325

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/09/2007

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