MEDICARE: WHITNEY ANDREW PA-C

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	363A00000X	Physician Assistant
2	363A00000X	Physician Assistant	0010-05663	NC

General Provider Information

NPI Number	:	1588051023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY ANDREW PA-C

Provider Business Mailing Address
First Line	:	6456 CODY ACRES TRL
Second Line	:
City	:	HURDLE MILLS
State	:	NC
Zip	:	27541-7414
Country	:	US
Telephone Number	:	919-769-6410
Fax Number	:

Provider Business Practice Location Address
First Line	:	5501 FORTUNES RIDGE DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-6102
Country	:	US
Telephone Number	:	919-391-7202
Fax Number	:

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

Provider Enumeration Date	:	04/22/2015
Last Update Date	:	06/02/2026

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Directions to “ WHITNEY ANDREW PA-C” Practice Location

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