Provider Demographics
NPI:1982252524
Name:TROTTER, WHITNEY NICHOLE (RD)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:NICHOLE
Last Name:TROTTER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:871 RIDGEWAY LOOP RD STE 108
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-4026
Mailing Address - Country:US
Mailing Address - Phone:512-630-8048
Mailing Address - Fax:
Practice Address - Street 1:871 RIDGEWAY LOOP RD STE 108
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-4026
Practice Address - Country:US
Practice Address - Phone:512-630-8048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002504133V00000X
TN35587363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered