Provider Demographics
NPI:1760144307
Name:WHISENANT, DOROTHY SEALE (RPH)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:SEALE
Last Name:WHISENANT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 CRAFT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:38635-3249
Mailing Address - Country:US
Mailing Address - Phone:662-252-2285
Mailing Address - Fax:
Practice Address - Street 1:575 CRAFT ST
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:38635-3249
Practice Address - Country:US
Practice Address - Phone:662-252-2285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-07219183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist