Provider Demographics
NPI:1902478712
Name:KOST, WHITNEY MARY (MSPAS, PA-C)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:MARY
Last Name:KOST
Suffix:
Gender:F
Credentials:MSPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 UNIVERSITY DRIVE
Mailing Address - Street 2:BLDG 700
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707
Mailing Address - Country:US
Mailing Address - Phone:919-237-1337
Mailing Address - Fax:919-237-1625
Practice Address - Street 1:7850 BRIER CREEK PKWY UNIT 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-8900
Practice Address - Country:US
Practice Address - Phone:919-748-4878
Practice Address - Fax:919-748-4876
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC0010-13065363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program