Provider Demographics
NPI:1699059667
Name:STROUD, WHITNEY (NP)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:STROUD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 758
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-0758
Mailing Address - Country:US
Mailing Address - Phone:901-572-0005
Mailing Address - Fax:
Practice Address - Street 1:3036 CENTRE OAK WAY
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-6302
Practice Address - Country:US
Practice Address - Phone:901-572-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16179363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner