Provider Demographics
NPI:1215120936
Name:WHITAKER, ABBY MARIE (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:MARIE
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:MS
Other - First Name:ABBY
Other - Middle Name:MARIE
Other - Last Name:PRINTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-BC
Mailing Address - Street 1:104 N MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:ARCANUM
Mailing Address - State:OH
Mailing Address - Zip Code:45304-1327
Mailing Address - Country:US
Mailing Address - Phone:937-662-0181
Mailing Address - Fax:937-548-3552
Practice Address - Street 1:104 N MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:ARCANUM
Practice Address - State:OH
Practice Address - Zip Code:45304-1327
Practice Address - Country:US
Practice Address - Phone:937-662-0181
Practice Address - Fax:937-662-0188
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.09301-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily