Basic Information
Provider Information
NPI: 1528585684
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PYLES
FirstName: WHITNEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 701 N STATE OF FRANKLIN RD STE 2
Address2:  
City: JOHNSON CITY
State: TN
PostalCode: 376043645
CountryCode: US
TelephoneNumber: 4239264468
FaxNumber: 4239284838
Practice Location
Address1: 701 N STATE OF FRANKLIN RD STE 2
Address2:  
City: JOHNSON CITY
State: TN
PostalCode: 376043645
CountryCode: US
TelephoneNumber: 4239264468
FaxNumber: 4239284838
Other Information
ProviderEnumerationDate: 08/29/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X23030TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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