MEDICARE: ABIGAIL RUTH WHISNANT

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	106H00000X	Marriage & Family Therapist	20588A	NC

General Provider Information

NPI Number	:	1639018724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL RUTH WHISNANT

Provider Business Mailing Address
First Line	:	104 ANDERSON PARK
Second Line	:
City	:	YOUNGSVILLE
State	:	NC
Zip	:	27596-7473
Country	:	US
Telephone Number	:	254-613-0644
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 ANDERSON PARK
Second Line	:
City	:	YOUNGSVILLE
State	:	NC
Zip	:	27596-7473
Country	:	US
Telephone Number	:	254-613-0644
Fax Number	:

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

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/25/2026

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