Provider Demographics
NPI:1366145369
Name:WHITSON, ERICA LEA (APRN-BC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:LEA
Last Name:WHITSON
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1300 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KS
Mailing Address - Zip Code:67301-1557
Mailing Address - Country:US
Mailing Address - Phone:620-714-1650
Mailing Address - Fax:
Practice Address - Street 1:800 W LAUREL ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-3211
Practice Address - Country:US
Practice Address - Phone:620-332-3280
Practice Address - Fax:620-332-3281
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS77335363LF0000X
KSTMP-161520207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine