Provider Demographics
NPI:1750856951
Name:PAHL, WHITNEY (NP-C)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:PAHL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 INTERNATIONAL CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3139
Mailing Address - Country:US
Mailing Address - Phone:719-475-5065
Mailing Address - Fax:719-475-5797
Practice Address - Street 1:2350 INTERNATIONAL CIR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3139
Practice Address - Country:US
Practice Address - Phone:719-475-5065
Practice Address - Fax:719-475-5797
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0994187363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily