Provider Demographics
NPI:1295927796
Name:WHITLEY, KATHRYN LYNN (NP)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:LYNN
Last Name:WHITLEY
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Gender:F
Credentials:NP
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Mailing Address - Street 1:PO BOX 1032
Mailing Address - Street 2:HENRY MARTINSVILLE HEALTH DEPARTMENT
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24114
Mailing Address - Country:US
Mailing Address - Phone:276-638-2311
Mailing Address - Fax:276-638-3537
Practice Address - Street 1:295 COMMONWEALTH BLVD
Practice Address - Street 2:HENRY MARTINSVILLE HEALTH DEPARTMENT
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24114
Practice Address - Country:US
Practice Address - Phone:276-638-2311
Practice Address - Fax:276-638-3537
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024164699363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily