Provider Demographics
NPI:1588922405
Name:WHITNEY, KRISTEN (DO)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:125 EMERYVILLE DR STE 107
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5020
Mailing Address - Country:US
Mailing Address - Phone:724-741-3120
Mailing Address - Fax:724-741-3201
Practice Address - Street 1:490 E NORTH AVE STE 107
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4740
Practice Address - Country:US
Practice Address - Phone:412-359-3376
Practice Address - Fax:412-359-5094
Is Sole Proprietor?:No
Enumeration Date:2012-04-28
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS018262207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA13804562OtherCAQH
PA103335902-Medicaid