Provider Demographics
NPI:1114351319
Name:WILLS, WHITNEY MICHELLE (FNP)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:MICHELLE
Last Name:WILLS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:MICHELLE
Other - Last Name:SHARPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1506 STACK ST APT 408
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4761
Mailing Address - Country:US
Mailing Address - Phone:901-292-3643
Mailing Address - Fax:
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-502-7707
Practice Address - Fax:410-502-7711
Is Sole Proprietor?:No
Enumeration Date:2013-08-25
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR197234363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily