Basic Information
| Provider Information | |||||||||
| NPI: | 1598168320 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WHISMAN | ||||||||
| FirstName: | MEGAN | ||||||||
| MiddleName: | LEANNE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1634 11TH ST | ||||||||
| Address2: | |||||||||
| City: | PORTSMOUTH | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456624526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403557102 | ||||||||
| FaxNumber: | 7403533083 | ||||||||
| Practice Location | |||||||||
| Address1: | 717 5TH ST | ||||||||
| Address2: | |||||||||
| City: | PORTSMOUTH | ||||||||
| State: | OH | ||||||||
| PostalCode: | 456624007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403546605 | ||||||||
| FaxNumber: | 7403541565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2014 | ||||||||
| LastUpdateDate: | 02/03/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | COA.16664-NP | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.