Provider Demographics
NPI:1083374037
Name:DYER, WHITNEY
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:DYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16356 COUNTY ROAD 41
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:AL
Mailing Address - Zip Code:35540-2416
Mailing Address - Country:US
Mailing Address - Phone:256-747-1186
Mailing Address - Fax:701-738-9043
Practice Address - Street 1:16356 COUNTY ROAD 41
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:AL
Practice Address - Zip Code:35540-2416
Practice Address - Country:US
Practice Address - Phone:256-747-1186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-17
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-154427363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily