Provider Demographics
NPI:1265982524
Name:WHITSON, CALEB MCCARLEY (CRNP)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:MCCARLEY
Last Name:WHITSON
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3104 BLUE LAKE DR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2345
Mailing Address - Country:US
Mailing Address - Phone:334-247-8769
Mailing Address - Fax:334-377-4417
Practice Address - Street 1:3104 BLUE LAKE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-2345
Practice Address - Country:US
Practice Address - Phone:334-247-8769
Practice Address - Fax:334-377-4417
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-146092363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner