MEDICARE: CIARA WHITT

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	1-139915	AL

General Provider Information

NPI Number	:	1881211647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIARA WHITT

Provider Business Mailing Address
First Line	:	26 MAPLE GROVE BLVD SW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35824-4005
Country	:	US
Telephone Number	:	205-765-5253
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 MAPLE GROVE BLVD SW
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35824-4005
Country	:	US
Telephone Number	:	205-765-5253
Fax Number	:

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

Provider Enumeration Date	:	06/28/2020
Last Update Date	:	06/28/2020

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Directions to “ CIARA WHITT ” Practice Location

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