Provider Demographics
NPI:1982176129
Name:NEWBERRY, WHITNEY FARREN
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:FARREN
Last Name:NEWBERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 WILLETTE RD
Mailing Address - Street 2:
Mailing Address - City:RED BOILING SPRINGS
Mailing Address - State:TN
Mailing Address - Zip Code:37150-3647
Mailing Address - Country:US
Mailing Address - Phone:615-699-3949
Mailing Address - Fax:
Practice Address - Street 1:120 PITCOCK LN
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TN
Practice Address - Zip Code:38551-4058
Practice Address - Country:US
Practice Address - Phone:931-243-3139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4738225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4738OtherTENNESSEE PHYSICAL THERAPIST ASSISTANT LICENSURE