Provider Demographics
NPI:1093729139
Name:MAULDIN, WHITNEY ROOP (AUD,FAAA,CCC-A)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:ROOP
Last Name:MAULDIN
Suffix:
Gender:F
Credentials:AUD,FAAA,CCC-A
Other - Prefix:MISS
Other - First Name:WHITNEY
Other - Middle Name:HEATHER
Other - Last Name:ROOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,FAAA,CCC-A
Mailing Address - Street 1:9724 KINGSTON PIKE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3347
Mailing Address - Country:US
Mailing Address - Phone:865-694-9870
Mailing Address - Fax:865-694-9871
Practice Address - Street 1:9724 KINGSTON PIKE
Practice Address - Street 2:SUITE 205
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3347
Practice Address - Country:US
Practice Address - Phone:865-694-9870
Practice Address - Fax:865-694-9871
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1197237600000X, 231H00000X, 231HA2500X
GA3590237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN31920111OtherMEDICARE NPI
TN4640001OtherUNITED HEALTH CARE
TN3148987OtherBLUECROSSBLUE SHIELD
TN4171594OtherBCBS
TN1504820Medicaid
TN3148987Medicaid