Provider Demographics
NPI:1417753310
Name:MATHIS, WHITNEY LOUISE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:LOUISE
Last Name:MATHIS
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 HUNTERS XING
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-6605
Mailing Address - Country:US
Mailing Address - Phone:803-349-6764
Mailing Address - Fax:
Practice Address - Street 1:2011 WINDSOR SPRING RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-4957
Practice Address - Country:US
Practice Address - Phone:706-798-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF12240020363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily