Provider Demographics
NPI:1639329576
Name:WILHITE, PATRICIA D (CRNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:D
Last Name:WILHITE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 COUNTY ROAD 1200
Mailing Address - Street 2:
Mailing Address - City:VINEMONT
Mailing Address - State:AL
Mailing Address - Zip Code:35179-4601
Mailing Address - Country:US
Mailing Address - Phone:256-531-4987
Mailing Address - Fax:
Practice Address - Street 1:40131 COUNTY ROAD 1141
Practice Address - Street 2:
Practice Address - City:VINEMONT
Practice Address - State:AL
Practice Address - Zip Code:35179
Practice Address - Country:US
Practice Address - Phone:256-531-4987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-073810363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner