Provider Demographics
NPI:1245743624
Name:MCCLUNG, WHITNEY LEE (APRN, AGACNP)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:LEE
Last Name:MCCLUNG
Suffix:
Gender:F
Credentials:APRN, AGACNP
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:LEE
Other - Last Name:KYSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1411 N BECKLEY AVE
Mailing Address - Street 2:PAVILION III, SUITE 152
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1411 N BECKLEY AVE
Practice Address - Street 2:PAVILION III, SUITE 152
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203
Practice Address - Country:US
Practice Address - Phone:214-948-2076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP135736363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care