Provider Demographics
NPI:1760780449
Name:WHITSON, VALERIE (PA-C)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:WHITSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:CONROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:131 BARNHILL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701
Mailing Address - Country:US
Mailing Address - Phone:479-575-4889
Mailing Address - Fax:479-575-3334
Practice Address - Street 1:4301 W MARKHAM ST # 783
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-686-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-04
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA-735363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant