Provider Demographics
NPI:1467547539
Name:WHITLEDGE, CAROLE PROCTOR (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:PROCTOR
Last Name:WHITLEDGE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9016 COLLINGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1419
Mailing Address - Country:US
Mailing Address - Phone:502-287-5894
Mailing Address - Fax:
Practice Address - Street 1:800 ZORN AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1433
Practice Address - Country:US
Practice Address - Phone:502-287-5894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1033972163WG0100X
KY2886P363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health