MEDICARE: MS. BIANCA YVETTE WHITLOW APRN

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	363LA2200X	Adult Health Nurse Practitioner	3018537	KY

General Provider Information

NPI Number	:	1316643000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BIANCA YVETTE WHITLOW APRN

Provider Business Mailing Address
First Line	:	1780 NICHOLASVILLE RD STE 202
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-1412
Country	:	US
Telephone Number	:	859-260-5051
Fax Number	:	859-260-5052

Provider Business Practice Location Address
First Line	:	1780 NICHOLASVILLE RD STE 202
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-1412
Country	:	US
Telephone Number	:	859-260-5051
Fax Number	:	859-260-5052

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

Provider Enumeration Date	:	02/03/2023
Last Update Date	:	10/31/2024

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