Provider Demographics
NPI:1053733741
Name:HARRISON-BIRMINGHAM, WHITNEY JANE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:JANE
Last Name:HARRISON-BIRMINGHAM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:JANE
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:890 W ELLIOT RD
Mailing Address - Street 2:STE 103
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5102
Mailing Address - Country:US
Mailing Address - Phone:480-545-2787
Mailing Address - Fax:
Practice Address - Street 1:890 W ELLIOT RD
Practice Address - Street 2:STE 103
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5102
Practice Address - Country:US
Practice Address - Phone:480-545-2787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant