| NPI | 1093962714 | 
|---|---|
| Professional Name | CAROL MANNING WHITESIDES | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 197834-8900) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 1978348900) | 
| Enumeration Date | 2008-08-25 | 
| Last Update Date | 2008-08-25 |