Kelly Lynn Whitaker, PHARMD, CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

20410432 Issued in KY

Practice address

2670 New Holt Rd Ste D
Paducah, KY 42001-7506

Phone

(270) 444-7070

NPI assigned

Oct 22, 2008

Last updated

Dec 4, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1558514489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 NEW HOLT RD STE D",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017506",
            "telephone_number": "270-444-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 NEW HOLT RD STE D",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017506",
            "telephone_number": "270-444-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHARMD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-22",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "KY",
            "license": "20410432",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "011861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Westowne Pharmacy Inc
• Teresa A Wheeler
• William Glenn Wheeler II, M.D.
• Joanna L Whelan
• Brittany Whistle, CRNA
• Whitney Whitaker, COTA/L
• White & White Family Dentistry PSC
• Brittany Kay White
• Kelvin L White, DMD
• Gary H. Whitelock, DMD

• Diabetes Educator Registered Nurse in Paducah, KY
• Providers in Paducah, KY by specialty
• Diabetes Educator Registered Nurse in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.