Provider Demographics
NPI:1285698712
Name:WHITTED, GINGER BETH (CRNA)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:BETH
Last Name:WHITTED
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:GINGER
Other - Middle Name:BETH FLOYD
Other - Last Name:WHITTED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8918 N LAGOON DR
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32408-4338
Mailing Address - Country:US
Mailing Address - Phone:229-225-6333
Mailing Address - Fax:334-279-1660
Practice Address - Street 1:204B E 19TH ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4707
Practice Address - Country:US
Practice Address - Phone:850-397-4355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008694367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00191383OtherPALMETTO
GAQ32303Medicare UPIN
GAP00191383OtherPALMETTO