Whitney, Gary Keith

Whitney, Gary Keith is an individual health care provider with primary practice located at 5050 N Clinton St , Fort Wayne IN 46825-5886. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Whitney, Gary Keith can be contacted via phone (260) 484-8551.

Contact Information

Primary practice address
5050 N Clinton St Fort Wayne IN 46825-5886
Phone: (260) 484-8551
Fax: (260) 482-5060
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 28110814A Indiana

Profile Details

NPI number 1376814798
LBN Legal business name Whitney, Gary Keith
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2012
Last updated Oct 30th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376814798 NPPES
Indiana MEDICAID 201059130

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