Provider Demographics
NPI:1538641204
Name:PINKERTON, WHITNI LAUREN (AGACNP)
Entity Type:Individual
Prefix:
First Name:WHITNI
Middle Name:LAUREN
Last Name:PINKERTON
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:WHITNI
Other - Middle Name:LAUREN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4909 GREAT RIVER DRIVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305
Mailing Address - Country:US
Mailing Address - Phone:601-282-8980
Mailing Address - Fax:601-693-6561
Practice Address - Street 1:4909 GREAT RIVER DRIVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305
Practice Address - Country:US
Practice Address - Phone:601-282-8980
Practice Address - Fax:601-693-6561
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902680363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology