Provider Demographics
NPI:1720273592
Name:NEWBERRY, WHITNEY LEIGH (APRN)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:LEIGH
Last Name:NEWBERRY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-3423
Mailing Address - Country:US
Mailing Address - Phone:620-888-4252
Mailing Address - Fax:833-973-5255
Practice Address - Street 1:1100 W 8TH ST
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-3423
Practice Address - Country:US
Practice Address - Phone:620-888-4252
Practice Address - Fax:833-973-5255
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46071363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200483700AMedicaid