Provider Demographics
NPI:1407597818
Name:GARRETT, WHITNEY WARD (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:WARD
Last Name:GARRETT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1462 SAINT MARK RD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-7310
Mailing Address - Country:US
Mailing Address - Phone:478-697-7190
Mailing Address - Fax:
Practice Address - Street 1:817 GRIFFIN AVE
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-6718
Practice Address - Country:US
Practice Address - Phone:478-374-1801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-07
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA241454363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty