Provider Demographics
NPI:1972155224
Name:WHITING, ABBEY M (MPAS, PA-C)
Entity type:Individual
Prefix:
First Name:ABBEY
Middle Name:M
Last Name:WHITING
Suffix:
Gender:F
Credentials:MPAS, PA-C
Other - Prefix:
Other - First Name:ABBEY
Other - Middle Name:M
Other - Last Name:SCHWAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5200 S HIGHLAND DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-7003
Mailing Address - Country:US
Mailing Address - Phone:801-363-3356
Mailing Address - Fax:801-533-9613
Practice Address - Street 1:5200 S HIGHLAND DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-7003
Practice Address - Country:US
Practice Address - Phone:801-363-3356
Practice Address - Fax:801-533-9613
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11907741-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant