Provider Demographics
NPI:1326735481
Name:BAHNER, WHITNEY N (FNP-C)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:N
Last Name:BAHNER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:N
Other - Last Name:WATRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:32771 LUTMAN RD
Mailing Address - Street 2:
Mailing Address - City:SMITHTON
Mailing Address - State:MO
Mailing Address - Zip Code:65350-3605
Mailing Address - Country:US
Mailing Address - Phone:660-473-1559
Mailing Address - Fax:
Practice Address - Street 1:875 MO-5 HWY
Practice Address - Street 2:
Practice Address - City:TIPTON
Practice Address - State:MO
Practice Address - Zip Code:65081
Practice Address - Country:US
Practice Address - Phone:660-433-5541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023015009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily