Provider Demographics
NPI:1396009825
Name:WHALEY, KATHERINE JEAN (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JEAN
Last Name:WHALEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 TOWER RD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-5392
Mailing Address - Country:US
Mailing Address - Phone:605-343-7295
Mailing Address - Fax:605-343-0138
Practice Address - Street 1:3006 TOWER RD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-5392
Practice Address - Country:US
Practice Address - Phone:605-343-7295
Practice Address - Fax:605-343-0138
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD9919207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology