Provider Demographics
NPI:1427575992
Name:WHINNEN, KAITLYN JANE (AGACNP)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:JANE
Last Name:WHINNEN
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:KAITLYN
Other - Middle Name:JANE
Other - Last Name:TROFTGRUBEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:155 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8710
Mailing Address - Country:US
Mailing Address - Phone:386-231-3072
Mailing Address - Fax:
Practice Address - Street 1:155 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8710
Practice Address - Country:US
Practice Address - Phone:386-231-3072
Practice Address - Fax:910-715-1247
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1628406163W00000X
COARNP9469933363LA2100X
FLARNP9469933363LA2100X
NC5014182363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care