Provider Demographics
NPI:1669773511
Name:PERRY, WHITNEY DAWN (ARNP)
Entity type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:DAWN
Last Name:PERRY
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Gender:F
Credentials:ARNP
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Mailing Address - Street 1:2700 STANLEY GAULT PKWY
Mailing Address - Street 2:STE 129
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5176
Mailing Address - Country:US
Mailing Address - Phone:502-253-4917
Mailing Address - Fax:502-489-5751
Practice Address - Street 1:4003 KRESGE WAY
Practice Address - Street 2:STE 500
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4652
Practice Address - Country:US
Practice Address - Phone:502-897-1166
Practice Address - Fax:502-897-1461
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2020-12-07
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Provider Licenses
StateLicense IDTaxonomies
KY3003387363L00000X
KY3006687363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000057119OOtherHUMANA - NCMA
KY000000706087OtherANTHEM - NCMA
KY124768OtherSIHO - NCMA
KY50032651OtherPASSPORT & PASSPORT ADVANTAGE - NCMA
KY7100158280Medicaid
KY000000706087OtherANTHEM - NCMA