| NPI | 1336675610 |
|---|---|
| Former Name | NICHOLE WHATLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209015245) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.015245) |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2022-08-15 |