Provider Demographics
NPI:1568587251
Name:WHYTE, JAMES IV (ARNP)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:WHYTE
Suffix:IV
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 LILLIQUIN DR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31757-0275
Mailing Address - Country:US
Mailing Address - Phone:883-233-5138
Mailing Address - Fax:
Practice Address - Street 1:616 UNIVERSAL DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4787
Practice Address - Country:US
Practice Address - Phone:850-385-1839
Practice Address - Fax:850-386-8371
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9199867363LF0000X
GA143028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily