Provider Demographics
NPI:1578954392
Name:MIDDLETON, WHITNEY M (AGPCNP)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:M
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:MS
Other - First Name:WHITNEY
Other - Middle Name:M
Other - Last Name:BURNIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 SANTA FE ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2338
Mailing Address - Country:US
Mailing Address - Phone:361-884-9900
Mailing Address - Fax:361-884-9903
Practice Address - Street 1:1215 SANTA FE ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2338
Practice Address - Country:US
Practice Address - Phone:361-884-9900
Practice Address - Fax:361-884-9903
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK116998363L00000X
TXAP127270363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX360230201Medicaid
TX507412YLPSOtherWELLMED PTAN