Provider Demographics
NPI:1114400504
Name:EDWARDS, WHITNEY ELAINE (FNP)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ELAINE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:EDWARDS
Other - Last Name:PETTIJOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:375 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-6644
Mailing Address - Country:US
Mailing Address - Phone:520-578-6099
Mailing Address - Fax:
Practice Address - Street 1:375 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-6644
Practice Address - Country:US
Practice Address - Phone:520-547-6099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTAP11773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily