MEDICARE: TREVOR DYLAN WHIPKER

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	363LF0000X	Family Nurse Practitioner	F08181163	IN

General Provider Information

NPI Number	:	1326513268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TREVOR DYLAN WHIPKER

Provider Business Mailing Address
First Line	:	6047 CHINKAPIN DR
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-8447
Country	:	US
Telephone Number	:	812-374-8389
Fax Number	:

Provider Business Practice Location Address
First Line	:	4010 W GOELLER BLVD STE A
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-8312
Country	:	US
Telephone Number	:	812-964-5056
Fax Number	:	888-571-6064

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

Provider Enumeration Date	:	10/08/2018
Last Update Date	:	08/29/2025

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