Provider Demographics
NPI:1578964532
Name:WHITNEY, KALI VAN BUSKIRK (PA-C)
Entity type:Individual
Prefix:
First Name:KALI
Middle Name:VAN BUSKIRK
Last Name:WHITNEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KALI
Other - Middle Name:ELIZABETH
Other - Last Name:VAN BUSKIRK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:7110 PRESTON RD STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3412
Practice Address - Country:US
Practice Address - Phone:972-526-0910
Practice Address - Fax:844-275-5790
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA09242363A00000X, 363AM0700X
NY018789363A00000X
FLPA9113067363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical