Provider Demographics
NPI:1548740616
Name:TOBIN, WHITNEY E (PA-C)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:E
Last Name:TOBIN
Suffix:
Gender:F
Credentials:PA-C
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 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-464-6944
Mailing Address - Fax:757-464-6952
Practice Address - Street 1:4445 CORPORATION LN STE 120
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3666
Practice Address - Country:US
Practice Address - Phone:757-464-6944
Practice Address - Fax:757-464-6952
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA55877363A00000X
VA0110007167363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant