Provider Demographics
NPI:1598974537
Name:WHISNANT, DAN (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:DAN
Middle Name:
Last Name:WHISNANT
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 MAZEPPA RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-7927
Mailing Address - Country:US
Mailing Address - Phone:704-664-7000
Mailing Address - Fax:704-663-3271
Practice Address - Street 1:119 MAZEPPA RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-7927
Practice Address - Country:US
Practice Address - Phone:704-664-7000
Practice Address - Fax:704-663-3271
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201636363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC201636OtherNC LICENSE
NCMW0851887OtherDEA #
NCMW0851887OtherDEA #