Provider Demographics
NPI:1114475357
Name:WHITMIRE, KATHERINE HINTON (APRN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:HINTON
Last Name:WHITMIRE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:HINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:6355 S BUFFALO DR FL 3
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-2133
Practice Address - Country:US
Practice Address - Phone:702-479-4881
Practice Address - Fax:702-966-8662
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN90934163W00000X
SC227390163W00000X
NVAPRN002439163WD0400X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1114475357Medicaid
NV1114475357Medicaid