Provider Demographics
NPI:1588099477
Name:WHITTY, ANGELLE VOSBURG (FNP)
Entity type:Individual
Prefix:
First Name:ANGELLE
Middle Name:VOSBURG
Last Name:WHITTY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 PICARDY AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3685
Mailing Address - Country:US
Mailing Address - Phone:225-308-0247
Mailing Address - Fax:225-308-0249
Practice Address - Street 1:8401 PICARDY AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3685
Practice Address - Country:US
Practice Address - Phone:225-308-0247
Practice Address - Fax:225-308-0249
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07496363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2347144Medicaid
LA2347144Medicaid