Basic Information
| Provider Information | |||||||||
| NPI: | 1831448059 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CREED | ||||||||
| FirstName: | WHITNEY | ||||||||
| MiddleName: | LAUREN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8147 | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319088147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063202773 | ||||||||
| FaxNumber: | 7065964226 | ||||||||
| Practice Location | |||||||||
| Address1: | 2122 MANCHESTER EXPY | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 319046878 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063202773 | ||||||||
| FaxNumber: | 7065964226 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2012 | ||||||||
| LastUpdateDate: | 07/30/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN184601 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 003138446A | 05 | GA | MEDICAID | 003138446B | 05 | GA | MEDICAID | 170858 | 05 | AL | MEDICAID | 153714 | 05 | AL | MEDICAID |