Provider Demographics
NPI:1437426079
Name:GARREN, WHITNEY GALLOWAY (PA)
Entity Type:Individual
Prefix:MISS
First Name:WHITNEY
Middle Name:GALLOWAY
Last Name:GARREN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 602373
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2695 HENDERSONVILLE RD
Practice Address - Street 2:SUITE 204 VISTA FAMILY HEALTH
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-8576
Practice Address - Country:US
Practice Address - Phone:828-687-8647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2369PAMedicaid
NC8101692Medicaid
SC2369PAMedicaid
NCNC5554HMedicare PIN
NCNC5554KMedicare PIN
NCNC5554LMedicare PIN
NCNC5554BMedicare PIN
NCNC5554EMedicare PIN
NCNC5554DMedicare UPIN
NCNC5554CMedicare PIN
NCNC5554AMedicare UPIN
NC8101692Medicaid
NCNC5554GMedicare PIN
NCNC5554FMedicare PIN