Provider Demographics
NPI:1497111579
Name:PHILLIPS, WHITNEY LYNN (PAC)
Entity Type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:LYNN
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PAC
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Mailing Address - Street 1:242 INDIAN LAKE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-4323
Mailing Address - Country:US
Mailing Address - Phone:615-822-5660
Mailing Address - Fax:615-822-5611
Practice Address - Street 1:242 INDIAN LAKE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-4323
Practice Address - Country:US
Practice Address - Phone:615-822-5660
Practice Address - Fax:615-822-5611
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2018-04-11
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ034864Medicaid