Basic Information
Provider Information
NPI: 1467811950
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGARRY
FirstName: WHITNEY
MiddleName: FORD
NamePrefix: MRS.
NameSuffix:  
Credential: CPNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 517 S SHARON AMITY RD
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282112975
CountryCode: US
TelephoneNumber: 7043848800
FaxNumber: 7043848819
Practice Location
Address1: 517 S SHARON AMITY RD
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282112975
CountryCode: US
TelephoneNumber: 7043848800
FaxNumber: 7043848819
Other Information
ProviderEnumerationDate: 02/12/2016
LastUpdateDate: 10/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200X5008371NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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