Most Relevant Information
Provider Data
| NPI Number: | 1003315748 |
| Provider Name: | STEPHANIE WHITAKER |
| Entity Type: | Individual |
| Taxonomy Code: | 163WH0200X |
| Specialty: | Registered Nurse |
| License Number: | 801846 |
Most Important Dates
| Enumeration Date: | 02/08/2018 |
| Last Updated: | 02/08/2018 |
Provider Practice Location
5528 COUNTY ROAD 874
CUSHING
TX
757605186
Practice Location Phone/Fax
| Phone: | 9362342955 |
| Fax: |
Provider Mailing Location
5528 COUNTY ROAD 874
CUSHING
TX
757605186
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |