Basic Information
| Provider Information | |||||||||
| NPI: | 1669742508 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WHITENER | ||||||||
| FirstName: | TRICIA | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 411 LANTERN BEND DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770902833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814443278 | ||||||||
| FaxNumber: | 8322493750 | ||||||||
| Practice Location | |||||||||
| Address1: | 411 LANTERN BEND DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770902833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814443278 | ||||||||
| FaxNumber: | 8322493750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2012 | ||||||||
| LastUpdateDate: | 09/28/2012 | ||||||||
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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 | 363LA2100X | 825049 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.