Provider Demographics
NPI:1972838969
Name:WHITEHURST, RAMONA L (CNM)
Entity Type:Individual
Prefix:
First Name:RAMONA
Middle Name:L
Last Name:WHITEHURST
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:RAMONA
Other - Middle Name:WHITEHURST
Other - Last Name:VON PRITTWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1400 WILLOW ROAD
Mailing Address - Street 2:
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361
Mailing Address - Country:US
Mailing Address - Phone:918-864-6171
Mailing Address - Fax:918-824-1171
Practice Address - Street 1:1400 WILLOW ROAD
Practice Address - Street 2:
Practice Address - City:PRYOR
Practice Address - State:OK
Practice Address - Zip Code:74361
Practice Address - Country:US
Practice Address - Phone:918-864-6171
Practice Address - Fax:918-824-1171
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-08
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK83576367A00000X
CA1862367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife