Provider Demographics
NPI:1356772941
Name:WHITFORD, FLORENTINA V (NP-C)
Entity type:Individual
Prefix:
First Name:FLORENTINA
Middle Name:V
Last Name:WHITFORD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 WILKINSON DR
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-2085
Mailing Address - Country:US
Mailing Address - Phone:731-285-5133
Mailing Address - Fax:
Practice Address - Street 1:420 WILKINSON DR
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-2085
Practice Address - Country:US
Practice Address - Phone:731-285-5133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-06
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25259363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner