Provider Demographics
NPI:1154372548
Name:WHITTY, SUSAN RENEE (ARNP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:RENEE
Last Name:WHITTY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:RENEE
Other - Last Name:KLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 MERCY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-7303
Mailing Address - Country:US
Mailing Address - Phone:563-582-0145
Mailing Address - Fax:563-582-0722
Practice Address - Street 1:200 MERCY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-7303
Practice Address - Country:US
Practice Address - Phone:563-582-0145
Practice Address - Fax:562-582-0722
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG06483363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health