Provider Demographics
NPI:1710454202
Name:SHAW, WHITNEY WILKERSON (MSN, APRN NP-C)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:WILKERSON
Last Name:SHAW
Suffix:
Gender:F
Credentials:MSN, APRN NP-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:WHITNEY
Other - Last Name:WILKERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN NP-C
Mailing Address - Street 1:3409 WORTH ST STE 710
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2061
Mailing Address - Country:US
Mailing Address - Phone:214-823-2533
Mailing Address - Fax:214-823-3270
Practice Address - Street 1:3409 WORTH ST STE 710
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2061
Practice Address - Country:US
Practice Address - Phone:214-823-2533
Practice Address - Fax:214-823-3270
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138449363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily