Provider Demographics
NPI:1912216052
Name:WHITMILL, DANIEL MICHAEL (CRNA-APRN)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:MICHAEL
Last Name:WHITMILL
Suffix:
Gender:M
Credentials:CRNA-APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 SONOMA LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-5881
Mailing Address - Country:US
Mailing Address - Phone:405-535-1990
Mailing Address - Fax:
Practice Address - Street 1:2220 W IOWA AVE
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-2738
Practice Address - Country:US
Practice Address - Phone:405-779-2834
Practice Address - Fax:405-779-2143
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK70242367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200312810AMedicaid
OK0KAAA1188Medicare PIN