Provider Demographics
NPI:1700250339
Name:WHITTINGTON, KATHRYN ABBIGAIL (PA-C)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ABBIGAIL
Last Name:WHITTINGTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF ANESTHESIOLOGY DUMC
Mailing Address - Street 2:2301 ERWIN ROAD, DUMC BOX 3094
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-681-9660
Mailing Address - Fax:919-681-4698
Practice Address - Street 1:DEPARTMENT OF ANESTHESIOLOGY DUMC
Practice Address - Street 2:2301 ERWIN ROAD, DUMC BOX 3094
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-681-9660
Practice Address - Fax:919-681-4698
Is Sole Proprietor?:No
Enumeration Date:2015-11-19
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-05846363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCR125AOtherMEDICARE PTAN